AccountId: 011433970860
ContactId: bdc1bc16-c3f0-4638-a7d1-89e8b1cb0f2c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 342760 ms
Total Talk Time (AGENT): 134616 ms
Total Talk Time (CUSTOMER): 129707 ms
Interruptions: 2
Overall Sentiment: AGENT=0.8, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/11/bdc1bc16-c3f0-4638-a7d1-89e8b1cb0f2c_20250411T17:50_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII]. I'm calling from products office to check the claim status.
[AGENT][NEUTRAL] OK, you're needing to check claim status, is that correct?
[CUSTOMER][POSITIVE] That's right.
[AGENT][POSITIVE] Yes, I can help you with that. And who am I speaking with again?
[CUSTOMER][NEUTRAL] My name is [PII], spelled as [PII].
[AGENT][NEUTRAL] OK, [PII], thank you, and your call back number please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And how many claims Mora do you have to check status on?
[CUSTOMER][NEUTRAL] Yes. Uh, may I know the claim status for the date of service of [PII]?
[AGENT][NEUTRAL] OK, so, OK, just one moment, how many claims do you have to check status on?
[CUSTOMER][NEUTRAL] Oh, sorry, it's only one.
[AGENT][NEUTRAL] OK. Yes, sir. I can help you. And what is the patient's policy number?
[CUSTOMER][NEUTRAL] Yes, the policy number to be 02377454 M as in Mike L as in Lima 8.
[AGENT][NEUTRAL] OK, thank you one moment while I get the member's information pulled up please.
[AGENT][NEUTRAL] And really any information that I do provide for you today will be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth?
[CUSTOMER][NEUTRAL] Yes, it's uh Mvoo.
[CUSTOMER][NEUTRAL] [PII] and then date of birth is [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] And and what is the data service and total bill amount?
[CUSTOMER][NEUTRAL] Yes, the data service is [PII]. Bill amount is, it's a $481 even.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] And the mother.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, and you said that the date of service is [PII], is that correct?
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][POSITIVE] That's right.
[AGENT][NEUTRAL] OK, we do not have a claim on file for that data service.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK, you find the number?
[AGENT][NEUTRAL] I did find a member and we do not have a claim on file for data service 626-2024.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] If you will be filing a claim to APL, you will also need to include a copy of the primary insurance company's explanation of benefits along with the claim.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] We do have to have that and then once we have processed the claim here at APL Morale, we do have a portal that you should be able to check claim status in by going to secured.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Oh, OK. Um, actually, previous one stated that that this claim is the faxed to you and the fax number is, it's [PII].
[AGENT][POSITIVE] That is correct.
[AGENT][NEGATIVE] Attention plain.
[CUSTOMER][NEUTRAL] OK, we already sent that uh claim with uh, yes, yes, we already sent the claim with the primary UOB on [PII], 0 sorry, it's [PII].
[AGENT][NEUTRAL] Yes
[AGENT][NEUTRAL] And we did
[AGENT][NEGATIVE] Yes, so we, for whatever reason, [PII], no, we did not receive that.
[CUSTOMER][NEGATIVE] I did not receive?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, may I know the member's effective date and term mission date?
[AGENT][NEUTRAL] The effective date is [PII].
[AGENT][NEUTRAL] And there is no term date, the policy is active.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] OK, this plan is that the commercial plan or the workers' compensation plan?
[AGENT][NEUTRAL] It is not workers' compensation. This is a supplemental policy to the primary health care insurance.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Oh OK.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. Well, is there anything? You're welcome. Is there anything else I can help you with today?
[CUSTOMER][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEGATIVE] No, nothing.
[AGENT][POSITIVE] OK, well then thank you so much for calling APL and I hope you have a great weekend.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, you too. Bye-bye.
[AGENT][POSITIVE] Ah, thank you. Bye-bye.
[CUSTOMER][NEUTRAL] They