AccountId: 011433970860
ContactId: c21573f6-ab3a-4518-9a92-6279abf2863c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 297250 ms
Total Talk Time (AGENT): 96557 ms
Total Talk Time (CUSTOMER): 108390 ms
Interruptions: 1
Overall Sentiment: AGENT=0.8, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/24/c21573f6-ab3a-4518-9a92-6279abf2863c_20250224T22:50_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi [PII]. My name is [PII] and I'm calling for Hope Neurology to check on a claim status.
[AGENT][NEUTRAL] OK, and [PII], what is the policy number, please?
[CUSTOMER][NEUTRAL] Uh yeah, sure. And please be informed me that this call is being recorded and monitored for the quality and training purpose. Your member ID number is.
[CUSTOMER][NEUTRAL] 669-448-50.
[AGENT][NEUTRAL] That's not one of our policy numbers. What's the patient's name, date of birth?
[CUSTOMER][NEUTRAL] So remember, first name is [PII]. It's spelled as [PII]. And my last name is [PII]. It's spelled as [PII].
[AGENT][NEUTRAL] OK. And the date of birth?
[CUSTOMER][NEUTRAL] And date of birth [PII].
[AGENT][NEUTRAL] And what state are they from?
[CUSTOMER][NEUTRAL] Uh, let me check.
[CUSTOMER][NEUTRAL] And also I have a social security number.
[AGENT][NEUTRAL] OK. But what's the, um, yeah.
[CUSTOMER][NEUTRAL] The status [PII].
[AGENT][NEUTRAL] What state are they from? I'm sorry, I must have missed it.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And [PII], a callback number in case the call drops?
[CUSTOMER][NEUTRAL] So the callback number is [PII] and it's a direct line.
[AGENT][NEUTRAL] OK, one moment, and this is for [PII]. Give me one moment.
[AGENT][NEUTRAL] I can give you her policy number with our company when you're ready.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Uh, policy number 1420113.
[AGENT][NEUTRAL] And what was the date of service and amount of the charge?
[CUSTOMER][NEUTRAL] Uh, sure, rate of service is [PII]. And this is for the bill amount of 30, uh, just a second.
[CUSTOMER][NEUTRAL] So on [PII] and uh
[CUSTOMER][NEUTRAL] Charge amount is?
[CUSTOMER][NEUTRAL] $200.02.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] You said data service in [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Uh, I do not show we received that claim. Uh, can you verify the address it was submitted to?
[CUSTOMER][NEUTRAL] Uh, let me check.
[CUSTOMER][NEUTRAL] May I know the pay ID?
[AGENT][NEUTRAL] 645-556.
[CUSTOMER][NEUTRAL] Yeah the member's policy with you and it also.
[AGENT][NEUTRAL] Uh, effective date is [PII] and the policy is active.
[CUSTOMER][NEUTRAL] And you are the 2nd insurance for this number, am I right?
[AGENT][NEUTRAL] Um, it could be primary or secondary.
[CUSTOMER][NEUTRAL] You don't have a COV information.
[AGENT][NEUTRAL] I'm sorry, we don't have any other information of any other policies they may have.
[CUSTOMER][NEUTRAL] Uh, OK.
[CUSTOMER][NEUTRAL] OK. May I know the client mailing address?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Attention to claims department.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] And the timely filing limit?
[AGENT][NEUTRAL] Uh, there isn't one.
[CUSTOMER][NEUTRAL] And the order of submission you prefer to submit a claims through paper or electronic.
[AGENT][NEUTRAL] Uh, either way is fine.
[CUSTOMER][NEUTRAL] OK, so submitting a claim need to change the member ID, right?
[AGENT][NEUTRAL] Well, that's, uh, you can change that policy number, that other number, I'm not sure if that's through IMA, but it's not one of our policy numbers.
[CUSTOMER][NEUTRAL] OK. And the current policy number is which you provided 1420113.
[AGENT][POSITIVE] Correct.
[AGENT][POSITIVE] Correct, yes, ma'am.
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] OK, and the mode of submission I prefer to some a cloud Mr. paper or electronic.
[AGENT][NEUTRAL] Uh, either way is fine.
[CUSTOMER][NEUTRAL] OK, and I'm ready for the call reference number.
[AGENT][NEUTRAL] Uh, we don't give reference numbers. So if you like, you may use my name in today's date.
[CUSTOMER][POSITIVE] Oh yeah, sure. And thank you so much for your assistance. You have a wonderful day.
[AGENT][POSITIVE] Alright, you too. Thanks for calling APL. Bye.
[CUSTOMER][POSITIVE] Thank you. Bye-bye.