AccountId: 011433970860
ContactId: b59ded1d-2107-4c94-8074-b313f5c5b21e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 333000 ms
Total Talk Time (AGENT): 89658 ms
Total Talk Time (CUSTOMER): 96189 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/30/b59ded1d-2107-4c94-8074-b313f5c5b21e_20250430T15:48_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] OK.
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII]. I'm checking on the claims.
[AGENT][NEUTRAL] OK, well, I'll be more than happy to help you with the claims, [PII], and how many claims do you have in total today?
[CUSTOMER][NEUTRAL] Uh, just one.
[AGENT][NEUTRAL] Alright, and may I have um a good contact number in case we're disconnected and then the policy number?
[CUSTOMER][NEUTRAL] Uh, sure. It's [PII].
[AGENT][POSITIVE] Thank you and the policy number whenever you're ready.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Just a moment, please.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right. That is 01666.
[CUSTOMER][NEUTRAL] 110
[CUSTOMER][NEUTRAL] M. like Mary, L. like Lamp.
[CUSTOMER][NEUTRAL] 8
[AGENT][NEUTRAL] Thank you for that. And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Uh, sure. It's uh [PII]. And date of birth, I'm sorry. Date of birth is [PII] for [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And may I have the date of service and the total bills for the claim?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Uh, date of service is, uh,
[CUSTOMER][NEUTRAL] [PII] and it was for $319 and processed as a primary from BCBS.
[CUSTOMER][NEUTRAL] The co-pay um transferred to you.
[CUSTOMER][NEUTRAL] $81.81.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] You said the total bill is $319?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh yes.
[AGENT][NEUTRAL] Alright, and [PII], is it OK if I place you on just a brief hold while I go through the claims?
[CUSTOMER][NEUTRAL] Uh, sure.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEUTRAL] Mhm. You are on hold.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 40 3, here we go.
[AGENT][POSITIVE] Wow.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Hello [PII].
[CUSTOMER][NEUTRAL] Mhm, yes.
[AGENT][POSITIVE] Thank you so much for holding. I apologize for that wait. And can you verify the name of the provider's office on the claim?
[CUSTOMER][NEUTRAL] Sure. It's uh Pytology Associates of South Miami.
[AGENT][NEUTRAL] The reason I'm asking is because we received, uh, we received three claims on that data service, none of them have this total bill of 319. And you said South Florida EMT Associates?
[CUSTOMER][NEUTRAL] You got it?
[CUSTOMER][NEUTRAL] Um, pathology Associates of South Florida, um, just a moment.
[CUSTOMER][NEUTRAL] It's pathology Associates of South Miami.
[AGENT][NEUTRAL] OK, and it's not with that provider. So we don't have a claim on file for your claim.
[CUSTOMER][NEUTRAL] OK, scan not on file. All right. So, so, uh, what's the family filing?
[AGENT][NEUTRAL] There's no timely filing as long as the policy was active on the data service, um, and this policy, oh, hold on one moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Yeah, this policy has been active since [PII]. Um, so you can file the claim at any time.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. All right. Thank you, [PII]. May I have the reference number for this call, please?
[AGENT][NEUTRAL] Sure, so there's no call reference number, but you can use my name and today's date. The first initial to my last name is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] All right, um, OK, alright, thank you, [PII].
[AGENT][POSITIVE] You're welcome. Was there anything else I can assist you with today?
[CUSTOMER][POSITIVE] Have a great day.
[CUSTOMER][POSITIVE] That's all. I appreciate it. Bye.
[AGENT][NEUTRAL] Yeah