AccountId: 011433970860
ContactId: b9611262-fa22-44ce-bd4f-f0efc129ae13
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 244100 ms
Total Talk Time (AGENT): 71482 ms
Total Talk Time (CUSTOMER): 75396 ms
Interruptions: 0
Overall Sentiment: AGENT=0, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/11/b9611262-fa22-44ce-bd4f-f0efc129ae13_20250211T18:03_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hello [PII], this is [PII] calling from the facility to get the status of the claim.
[AGENT][NEUTRAL] OK, I can verify claim status for you. And [PII], what is that policy number, please?
[CUSTOMER][NEUTRAL] It is D as in Delta 47688724.
[AGENT][NEUTRAL] Uh, it's not one of our policy numbers. Do you have the patient's policy certificate number? If not, what's the patient's name?
[CUSTOMER][NEUTRAL] It is [PII].
[CUSTOMER][NEUTRAL] K B
[AGENT][NEUTRAL] I'm sorry, spell that last name for me.
[CUSTOMER][NEUTRAL] Yeah, it's K as in Kilo I as in India, R as in Romeo, B as in Bravo, Y as in Yankee.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] And what's the patient's date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] I do not show that patient in our system. So going by the number you gave initially, that may be through IMA and I can give you their phone number and they can verify or claim status for you.
[CUSTOMER][NEUTRAL] Um, actually, uh, we have follow up on this members claim previously and, uh, it is showing that the patient was not active on the data service but, uh, somehow they're able to locate.
[AGENT][NEUTRAL] OK, well, I cannot locate.
[CUSTOMER][NEUTRAL] So can you check with like uh social security?
[AGENT][NEUTRAL] Well, the patient, I'm assuming is, well, is it under their name? Is the policy under their name or is it on another person's name?
[CUSTOMER][NEUTRAL] Mm, let me check it.
[CUSTOMER][NEUTRAL] So.
[CUSTOMER][NEUTRAL] And yeah, I believe it is in uh medical coverage employee [PII] and the
[AGENT][NEUTRAL] So [PII] is the last name?
[CUSTOMER][NEUTRAL] I, yes.
[CUSTOMER][NEUTRAL] [PII] uh sorry, [PII]
[AGENT][NEUTRAL] I don't show that person in our system. Do you have a copy of their card with APL?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, on the card,
[CUSTOMER][NEUTRAL] Yes, I'm currently looking at it.
[AGENT][NEUTRAL] OK, on the card, do you see a policy er number or policy slash certificate number?
[AGENT][NEUTRAL] Should start with a 01 or 02?
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Um, no, it is showing only employee ID employee name, and it is in the search or multi plan.
[AGENT][NEUTRAL] OK, yeah, I don't show that person in our system. Um, do you see a number to IMA? I can give you their phone number and they can verify a claim status for you, but I do not show that person in our system.
[CUSTOMER][NEUTRAL] OK, OK. Got it.