AccountId: 011433970860
ContactId: beba6d01-dccf-41ae-b9ae-8536678c3b9f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 246110 ms
Total Talk Time (AGENT): 141084 ms
Total Talk Time (CUSTOMER): 50401 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/03/beba6d01-dccf-41ae-b9ae-8536678c3b9f_20250203T21:12_UTC.wav
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[AGENT][NEUTRAL] Afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], I was calling to check on the status of a claim.
[AGENT][NEUTRAL] OK, you have one claim you're needing to check status on, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Yes, I can help you with that. And who am I speaking with, please?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] Thank you. And [PII], what is the callback number for you?
[CUSTOMER][NEUTRAL] [PII] that's a direct line there's no extension.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, thank you. And sir, do you spell your name with or without an [PII]?
[CUSTOMER][NEUTRAL] With
[AGENT][NEUTRAL] OK. Thank you. And the member's policy number, please?
[CUSTOMER][NEUTRAL] 249-687-2.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Any information that I do provide for you, sir, would be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] Mayor [PII], and her date of birth is [PII].
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] And what is the date of service and total bill amount for her?
[CUSTOMER][NEUTRAL] It is [PII] $245.
[AGENT][NEUTRAL] OK, let's.
[AGENT][NEUTRAL] OK, so there's no claim on this policy number for and I wanna make sure I heard you correctly, 9-13-2024?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK, this policy number that you gave me.
[AGENT][NEUTRAL] It's, it's, it went into effect in term the same day, [PII]. Let me see if there's another policy.
[AGENT][NEUTRAL] For her.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And there he is.
[AGENT][NEUTRAL] So just a moment I'll provide you that information and I'll check it to see if we received it and processed it on there.
[AGENT][NEUTRAL] So, the correct policy number you should have for this number is
[AGENT][NEUTRAL] 02569076.
[AGENT][NEUTRAL] And this policy has an effective date of [PII].
[AGENT][NEUTRAL] And we also do not have a claim on file for her for this data service on this policy either.
[AGENT][NEUTRAL] Now, because this is a supplemental policy, [PII], to their primary healthcare insurance, we will also have to have a copy of the primary insurance company's explanation of benefits.
[AGENT][NEUTRAL] As well for review.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then once we have processed our claim here at APL we do have a portal in which you should be able to check claim status and that portal website is secured.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] I'm there. I just, I don't have a claim number and I don't have the last four of the patient's social security number.
[AGENT][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] Yeah, because we don't
[AGENT][NEUTRAL] Right. And we don't have a claim on file, so there's no status to check.
[CUSTOMER][NEUTRAL] OK, and where would I, is there a fax number I could send that to or does it have to be mailed?
[AGENT][NEUTRAL] No, you can fax it. Our secured faxon is [PII]. Attention claims.
[CUSTOMER][NEUTRAL] Alright, thank you and [PII], do y'all provide reference numbers?
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] You would use my name along with today's date.
[CUSTOMER][POSITIVE] OK alright thank you so much for your help.
[AGENT][POSITIVE] Alright, well, you are certainly very welcome sir that's all I can help you with. Thank you again for calling APL and I hope you have a great evening.
[CUSTOMER][POSITIVE] Thank you, you too.