AccountId: 011433970860
ContactId: ba73e994-50a5-42f3-9f47-2188cc18c2fd
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 320859 ms
Total Talk Time (AGENT): 107360 ms
Total Talk Time (CUSTOMER): 107018 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/04/ba73e994-50a5-42f3-9f47-2188cc18c2fd_20250404T15:35_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yeah, hi [PII]. This is [PII] calling you from provider's office, and I'm here to look upon a patient's claim status and a specific question will let us know.
[AGENT][NEUTRAL] Sure, I just needed clarification on that, uh, claim.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Sure, OK, uh, [PII], can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] Of course, it is [PII] and this is another line.
[AGENT][NEUTRAL] OK, thank you. Uh, do you have that policy number?
[CUSTOMER][NEUTRAL] Yes, and that is 1448501 M like Mary, L Lima, the number 8.
[AGENT][NEUTRAL] OK, one moment. Uh what was the name and date of birth for the member?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] The member's first name is [PII], last name is [PII], with the date of birth of [PII].
[AGENT][POSITIVE] Perfect, thank you for verifying that [PII]. Do you have that claim number?
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Yeah, the claim number is, one moment, no, I don't have a claim number. I'm sorry.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Oh, that's OK. Uh, do you have that data service?
[CUSTOMER][NEUTRAL] Yeah, it is on uh.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] It's on [PII] with the billing amount of $306 even.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] 306. OK.
[AGENT][NEUTRAL] And I'm so sorry, [PII], would you mind uh verifying that date of birth for me one more time?
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Sure. It is [PII].
[AGENT][NEUTRAL] OK, thank you. There are 2 members with the same name on this policy, so I just wanted to make sure. Alrighty, give me just a moment.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] OK, so, uh, we are missing a copy of the primary EOB for this claim.
[CUSTOMER][NEUTRAL] Oh, aren't you the primary for this number?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Aren't you the primary for this member?
[AGENT][NEUTRAL] No, this is a secondary medical policy.
[CUSTOMER][NEUTRAL] So, may I know who is the primary policy number?
[AGENT][NEUTRAL] I don't have that information as this is just their secondary. I'm not sure who their primary is.
[CUSTOMER][NEUTRAL] OK, may I know the claim number?
[AGENT][NEUTRAL] Yes, that is 357 6.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] 372.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And may I have the date that was processed, the renewal date?
[AGENT][NEUTRAL] Yes, let's see, that was [PII].
[CUSTOMER][NEUTRAL] [PII]. OK.
[CUSTOMER][NEUTRAL] I need to process the claim. May I know the last CIP updated date?
[AGENT][POSITIVE] What was that? I'm so sorry.
[CUSTOMER][NEUTRAL] Uh, may I know the last, uh, coordination of benefits that was updated on?
[AGENT][NEUTRAL] So for this member I will say that this member was dropped from the policy on [PII], so that would be the last information we have for this number.
[CUSTOMER][NEUTRAL] OK, so.
[CUSTOMER][NEGATIVE] Never updated.
[CUSTOMER][NEUTRAL] And yeah, can you confirm the eligibility status of the member? Is this active during the date of service?
[AGENT][NEUTRAL] During the date of service, yes, that was um [PII], I believe. Yes, um, this number was dropped from the policy on [PII].
[CUSTOMER][NEUTRAL] Oh, OK, so they may I have the effective date?
[AGENT][NEUTRAL] Yes, effective date was [PII].
[CUSTOMER][NEUTRAL] Till [PII], right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you so much for that. And would you mind spelling out your name for my documentation?
[AGENT][NEUTRAL] Sure, it's [PII]
[AGENT][NEUTRAL] Was there anything else I could help you with, [PII]?
[CUSTOMER][NEUTRAL] A.
[CUSTOMER][NEUTRAL] Uh, no, may I have your last name and [PII], please.
[AGENT][NEUTRAL] Sure, it's A
[CUSTOMER][NEUTRAL] And the call reference number?
[AGENT][NEUTRAL] Reference number would just be my first name, last initial, and today's date.
[CUSTOMER][POSITIVE] Great, thank you so much for your assistance and have a wonderful rest of your day. Bye for now. Happy weekend.
[AGENT][POSITIVE] Of course, thanks for calling APL you too thank you bye bye.
[CUSTOMER][NEUTRAL] Bye bye.