AccountId: 011433970860
ContactId: bca34cad-35bc-41d2-8e5f-02b7edd67b13
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 344000 ms
Total Talk Time (AGENT): 147754 ms
Total Talk Time (CUSTOMER): 130386 ms
Interruptions: 0
Overall Sentiment: AGENT=1.9, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/09/bca34cad-35bc-41d2-8e5f-02b7edd67b13_20250109T19:50_UTC.wav
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[AGENT][POSITIVE] Good morning. I'm sorry, good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi there. I just need to check claim status, please.
[AGENT][POSITIVE] It would be my pleasure to assist you. May I ask your name?
[CUSTOMER][NEUTRAL] [PII]? And I'm so sorry, what was your name?
[AGENT][NEUTRAL] My name is [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] [PII], it would be my pleasure to assist you with claim status. What is a good callback number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you [PII], and the policy number for the patient, please.
[CUSTOMER][NEUTRAL] Uh, that is A for Alpha, 601253-5001.
[AGENT][NEUTRAL] Is that her primary insurance policy information?
[CUSTOMER][NEUTRAL] It should be.
[AGENT][NEUTRAL] A major medical, that's not APL.
[CUSTOMER][NEUTRAL] OK, let me pull up her insurance card again.
[CUSTOMER][NEUTRAL] Bear with me just a moment.
[AGENT][POSITIVE] Take your time. It's fine.
[CUSTOMER][NEGATIVE] Unfortunately, it's not saved in her main screen so I had to go to the images.
[AGENT][NEUTRAL] Mhm
[AGENT][POSITIVE] Not a problem.
[CUSTOMER][NEUTRAL] Uh, front.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It would help if I click the right one.
[AGENT][NEUTRAL] It's getting toward the end of the week.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Um, do do do do do.
[CUSTOMER][NEUTRAL] Do the date I'm just looking at the front of the card.
[AGENT][NEUTRAL] Is it an APL card?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So, on the front, it just says insured coverage group, effective date, and it has an in-hospital benefit and an outpatient.
[AGENT][NEUTRAL] Or outpatient, either one.
[CUSTOMER][NEUTRAL] Oh, OK. Um, that would be 02.
[CUSTOMER][NEUTRAL] 066393
[CUSTOMER][NEUTRAL] M as in Mary, L as in Lima, 7.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Perfect. And what is the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] Alright, I just hop by there real quick.
[CUSTOMER][NEUTRAL] All right. Name is [PII]. Birthday is [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And you are needing claim status, right?
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me check something real quick for you.
[AGENT][NEUTRAL] What's the date of service for that claim status?
[CUSTOMER][NEUTRAL] Data service is [PII], billed amount $470.
[AGENT][NEUTRAL] OK, so actually that policy number that you gave me termed on [PII]. [PII] does have active coverage, but it's under a different policy number. Can I give you the correct policy number for that data service?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] The correct policy number is going to be 246.
[AGENT][NEUTRAL] 2280
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And I'm checking for [PII]'s policy. We have no claims on file.
[AGENT][NEUTRAL] Forterra.
[CUSTOMER][NEUTRAL] OK, and the new or the old?
[AGENT][NEUTRAL] Correct, because I was checking the old one to see if we had any claims or we don't own either, and you can actually fax that claim with the primary EOB directly to our claims department.
[CUSTOMER][NEUTRAL] Oh, OK. Um, and I'm so sorry. What date was she affected from?
[AGENT][NEUTRAL] So this policy was active from [PII]. Um, yeah, but she's had active coverage on that other policy that you gave me.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, from 8121 to 1124, then they changed the policy number.
[CUSTOMER][NEUTRAL] OK, yeah, I'll just put this one in with this policy number and um the start of service so that it doesn't get confused for any claims from last year.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] And then what would be, let me just verify your PO box.
[AGENT][NEUTRAL] OK, our PO box.
[CUSTOMER][NEUTRAL] See if you sent it to the right one.
[AGENT][NEUTRAL] Sure, it's [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the zip code is [PII].
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][NEGATIVE] It looks like it may have gotten sent to the wrong address. Probably got sent to the one that.
[CUSTOMER][NEUTRAL] That you went to?
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] All right. And then if I could just spell you for a reference number, please?
[AGENT][POSITIVE] Reference number is my name and today's date, and I spell my name [PII]. And it was a pleasure to assist you with that claim status today, [PII], anything else?
[CUSTOMER][POSITIVE] That was it. Thank you so much for all of your help.
[AGENT][POSITIVE] And thank you for calling APL. I hope you have a wonderful day.
[CUSTOMER][POSITIVE] Thank you. You too.
[AGENT][POSITIVE] Thank you. Bye-bye.
[CUSTOMER][NEUTRAL] Bye bye.