AccountId: 011433970860
ContactId: c4742739-2e5a-43e6-ab75-912aad696db5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 265619 ms
Total Talk Time (AGENT): 118089 ms
Total Talk Time (CUSTOMER): 98482 ms
Interruptions: 1
Overall Sentiment: AGENT=1.2, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/31/c4742739-2e5a-43e6-ab75-912aad696db5_20250131T14:28_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], I wonder if you can check the status of the claim for me.
[AGENT][POSITIVE] Sure, I'll be more than happy to help you with the claim status, and are you the insured or calling from a provider's office or group?
[CUSTOMER][NEUTRAL] I'm the insured
[AGENT][NEUTRAL] OK, may I have your name and a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] It's [PII] [PII].
[AGENT][NEUTRAL] Thank you for that. And [PII], may I have your policy number?
[CUSTOMER][NEUTRAL] Uh, let's see.
[CUSTOMER][NEUTRAL] I got a group number and a payer ID policy number, sorry, 0212.
[CUSTOMER][NEUTRAL] 942 9
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And you've already given me your first and last name. I just need you to verify your date of birth, mailing, and email address on file.
[CUSTOMER][NEUTRAL] [PII] [PII].
[CUSTOMER][NEUTRAL] [PII] or [PII] [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And [PII], do you have the date of service for the claim?
[CUSTOMER][NEUTRAL] That was uh let's see, I just had it [PII].
[CUSTOMER][NEUTRAL] Hold on, uh, for [PII].
[AGENT][POSITIVE] Mhm, take your time.
[CUSTOMER][NEUTRAL] [PII], I think, let's see.
[CUSTOMER][NEUTRAL] No, uh, [PII].
[AGENT][NEUTRAL] [PII]. OK. Hold on one moment.
[AGENT][NEUTRAL] So I'm actually not showing any claims on file for [PII].
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] OK, I will call the provider.
[AGENT][NEUTRAL] All right, well, um,
[CUSTOMER][NEUTRAL] And um
[AGENT][NEUTRAL] Just in case they ask, let them know that there is no timely filing limit. So as long as your policy is active on the data service, they can file at any time and the policy was active on your data service, so they still have time.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, I just, I called them and they said they were gonna submit it and so I've been waiting and then now they sent me a past due bill and I'm like, well, we wonder what happens but if you look at that.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEGATIVE] Can you, can you see if there's any benefits still available? because maybe there's not, and this would be a waste of time.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] For 24, right?
[CUSTOMER][NEUTRAL] For, yeah, that date you mean or for that year?
[AGENT][NEUTRAL] Um, you, you just want me to check and see if there are any benefits left for the year, right?
[CUSTOMER][POSITIVE] Right, exactly, yeah.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Because I'm not sure there was.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] Calendar year.
[AGENT][NEUTRAL] Oh yeah, you only use $37.
[CUSTOMER][POSITIVE] Oh, sweet. So, so.
[AGENT][NEUTRAL] Last year, and.
[AGENT][NEUTRAL] I was, I, I was thinking I was looking at it wrong and I'm like, wait, so yes, but your, your max is 3000 and you use, um, let me go back, back to that screen. Hold on one second.
[CUSTOMER][NEUTRAL] I think 23 I probably used it up but not 24 maybe.
[AGENT][NEUTRAL] Yeah, for 2024, you only use $37.21.
[CUSTOMER][POSITIVE] OK, then I will get them to resubmit. Thank you so much or submit, I guess they did.
[AGENT][NEUTRAL] You're welcome. Was there any
[CUSTOMER][POSITIVE] No, that's great. Thank you.
[AGENT][NEUTRAL] Well,
[AGENT][NEUTRAL] And another thing, if they, if they are saying that they submitted it, you might want to give them our phone number and have them call us. I just don't, if they are saying they submitted it because we did have an old claims mailing address, sometimes they're still sending it to [PII] and it should be Oklahoma, so maybe that's what's going on too.
[CUSTOMER][NEUTRAL] Oh, OK. All right, I'll let them know that because I have the card here and it's got the Oklahoma on it, so I'll give them that.
[AGENT][POSITIVE] Alrighty, well, thank you so much for calling APL [PII]. I hope you have a great weekend.
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][POSITIVE] You too take care bye.
[AGENT][POSITIVE] Thank you. Bye-bye.