AccountId: 011433970860
ContactId: b49df9ba-b704-4fed-8ede-f7ed857dada8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 182179 ms
Total Talk Time (AGENT): 67209 ms
Total Talk Time (CUSTOMER): 73917 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/21/b49df9ba-b704-4fed-8ede-f7ed857dada8_20250221T14:25_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Thank you for calling APL. This is Easy. How can I help you?
[CUSTOMER][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Hello, I'm [PII] calling from the provider office checking on the claim status.
[CUSTOMER][NEUTRAL] So you have
[AGENT][NEUTRAL] I'm sure, [PII], I can assist you with benefits. Um, first, or claim status. First, I'll need a good callback number in case we're disconnected.
[CUSTOMER][NEUTRAL] [PII] direct line.
[AGENT][NEUTRAL] Thank you. Now, I need the policy number, please.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Policy number is 025.
[CUSTOMER][NEUTRAL] 53364. M as in Mary, L as in Lima, number 7.
[AGENT][NEUTRAL] Thank you. Now, please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Member's name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Thank you. Now I need the date of service and bill charges on the claim.
[CUSTOMER][NEUTRAL] [PII]. bill amount is $215 even.
[AGENT][NEUTRAL] OK, I'm not showing that claim on file for [PII]. Um, how was the claim submitted?
[CUSTOMER][NEUTRAL] OK. So, I actually, I'm unable to find this information. Just to verify this member's policy, is this APL insurance as a primary insurance for this?
[AGENT][NEUTRAL] No, we're secondary insurance.
[CUSTOMER][NEUTRAL] OK, so you're saying that APL is a secondary insurance, right?
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] According to you, who is the primary insurance for this one?
[AGENT][NEUTRAL] We don't have that information on file until we receive the claim from the provider.
[CUSTOMER][NEUTRAL] OK. Could you please provide me the COV last the date?
[AGENT][NEUTRAL] Well, I'm not showing any claims on file for this member.
[CUSTOMER][NEUTRAL] So, I'm asking you for the coordination of benefits last updated date.
[AGENT][NEUTRAL] Well, just let me advise you that verification of coverage does not guarantee payment of claims. Um, I'm showing the effective date on this policy was [PII] and the policy is still active.
[CUSTOMER][NEUTRAL] OK. And you're saying that um this insurance is not a primary insurance, right?
[AGENT][NEUTRAL] Right, it's not primary, it's secondary.
[CUSTOMER][POSITIVE] OK. Thank you so much. If you don't mind, could you please spell your name for documentation purpose?
[AGENT][NEUTRAL] Yes, my name is [PII]. It's spelled [PII] and my last initial is [PII]. Is there anything else that I can assist you with?
[CUSTOMER][NEUTRAL] And the call reference number, could you please provide me?
[AGENT][NEUTRAL] Yes, you can use my name and today's date for the reference number.
[CUSTOMER][POSITIVE] Thank you. That's all about for today's call. Stay safe. Bye for now.
[AGENT][NEUTRAL] OK, thank you, [PII], for calling ATL. You have a.