AccountId: 011433970860
ContactId: b2b91d7b-603e-4100-bad0-0cd027c72c0d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 332329 ms
Total Talk Time (AGENT): 146711 ms
Total Talk Time (CUSTOMER): 102221 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/02/b2b91d7b-603e-4100-bad0-0cd027c72c0d_20250402T16:27_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yes, I'm [PII]. I'm trying to get um claim status of where we need to send this claim to be filed because every time we send electronic it keeps coming back.
[AGENT][POSITIVE] Well, it would be my pleasure to assist you. May I ask your name?
[CUSTOMER][NEUTRAL] Is that
[AGENT][POSITIVE] And a good call back number, Doc.
[CUSTOMER][NEUTRAL] It's [PII] straight line.
[AGENT][NEUTRAL] Thank you. And do you have the patient's policy number so I can give you the correct um submission information?
[CUSTOMER][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yes, it's D as in Delta 43721451.
[AGENT][NEUTRAL] And that is not the APL policy number. Do you have a policy certificate number for APL?
[CUSTOMER][NEUTRAL] Mm, no.
[AGENT][NEUTRAL] Starting with a 0.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] No, they start with a D.
[AGENT][NEUTRAL] OK, so is it for 90 degree benefits or IMA?
[CUSTOMER][NEUTRAL] I think it's 90 degree benefit. I is that benefit in the car.
[AGENT][NEUTRAL] OK. So,
[AGENT][NEUTRAL] Their address for claims is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And that's Eagan. E A.
[CUSTOMER][NEUTRAL] And that's what we've been.
[AGENT][NEUTRAL] I'm sorry, go ahead.
[CUSTOMER][NEUTRAL] Right, that's what we've been sending. I'm sorry, that's why we've been sending it with the payer ID 64556.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Is it coming back to you or?
[CUSTOMER][NEUTRAL] And it keeps coming back.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] Yes, they keep rejected saying that they're um.
[CUSTOMER][NEUTRAL] What it is.
[CUSTOMER][NEUTRAL] Let me look it up and see.
[CUSTOMER][NEGATIVE] The payer ID is incorrect.
[AGENT][NEUTRAL] 645-556 is that number.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] Is it for a medical claim or preventive or wellness claim?
[CUSTOMER][NEUTRAL] Medical.
[AGENT][NEUTRAL] OK, let me check and see if the patient has an account with APL. What's the last name of the patient?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It's [PII]
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And the first name?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][POSITIVE] I, OK, thank you.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] OK. And what is [PII]'s date of birth?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] OK, so they do have a medical policy with our company APL and I can give you the correct policy number.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, is it, is this a [PII] claim it.
[AGENT][NEUTRAL] 2004.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] So this policy.
[AGENT][NEUTRAL] Let me just see.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] He did not have coverage with us during [PII].
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEGATIVE] He didn't have coverage at all. You just can't tell with APL.
[AGENT][NEUTRAL] Yeah, he's had coverage with APL since [PII], but not since [PII].
[AGENT][NEUTRAL] So that was prior to the date of coverage.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So I can be able to pay you because I don't have nothing else on file. It's the only thing I have.
[AGENT][NEUTRAL] I can't give you that information. Uh, that would be up to the provider.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I just know that his coverage began with APL on [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And it's still active?
[AGENT][NEUTRAL] Well, that policy term, well, he had coverage.
[AGENT][NEUTRAL] Um, on a policy from 8 118-21 to 8623.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And then he has active coverage with us from 4124 to current.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. Got it. OK.
[CUSTOMER][NEUTRAL] Alright, do you have a a reference number?
[AGENT][NEUTRAL] Reference number would be my name and today's date.
[AGENT][NEUTRAL] And I spell my name, [PII]
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] First initial last name is [PII].
[CUSTOMER][NEUTRAL] OK, and could you give me the correct um APL ID number now?
[AGENT][NEUTRAL] His active policy number.
[AGENT][NEUTRAL] Since 4124 with APL is 024.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 83344
[CUSTOMER][POSITIVE] Thank you so much [PII], you have a great day.
[AGENT][POSITIVE] My God, it's been my pleasure to help you with that eligibility. Thank you for calling APL, and I hope you have a wonderful day as well. Take care.
[CUSTOMER][NEUTRAL] You too. Bye-bye.
[AGENT][NEUTRAL] Bye bye.