AccountId: 011433970860
ContactId: c518543f-642c-4933-8998-7a5243cf152c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 547679 ms
Total Talk Time (AGENT): 137766 ms
Total Talk Time (CUSTOMER): 180841 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/27/c518543f-642c-4933-8998-7a5243cf152c_20250127T13:16_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, I'm [PII]. I'm calling from Jackson Health to check the claim status. Could you please go for that?
[AGENT][NEUTRAL] I'm sure, [PII], I can assist you with claim status. Um, first, could I get a good callback number just in case we're disconnected?
[CUSTOMER][NEUTRAL] Yeah, sure. My callback number is [PII].
[AGENT][NEUTRAL] OK. Thank you. Now, I need the policy number, please.
[CUSTOMER][NEUTRAL] OK, the policy number is 00262416.
[AGENT][NEUTRAL] OK. Please repeat that policy number.
[CUSTOMER][NEUTRAL] 00262416
[AGENT][NEUTRAL] OK. No one's coming up under that number. Um, do you have the social, the member's social security number?
[CUSTOMER][NEUTRAL] OK, wait a moment.
[CUSTOMER][NEUTRAL] Oh, no, I not have a social.
[AGENT][NEUTRAL] OK, I can look them up by name and date of birth. What's the last name?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. The member's first name is uh [PII] and the last name is [PII].
[CUSTOMER][NEUTRAL] And the date of birth is [PII].
[AGENT][NEUTRAL] OK. Could you please spell the last name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] A
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK. And what's her date of birth, please?
[CUSTOMER][NEUTRAL] OK. The date of birth is
[CUSTOMER][NEUTRAL] Um, wait a second.
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] You said February.
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Wait wait
[AGENT][NEUTRAL] OK. No one's coming up in our system under that name and date of birth?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I don't want, I will check that.
[AGENT][NEUTRAL] Is there anything else that I can assist you with?
[CUSTOMER][NEUTRAL] OK, wait. I have another one. Could you please check that? Yeah, the details.
[CUSTOMER][NEUTRAL] Can I say the member ID?
[AGENT][NEUTRAL] Yes, what's the member ID please?
[CUSTOMER][NEUTRAL] 022657.
[CUSTOMER][NEUTRAL] 90
[CUSTOMER][NEUTRAL] M as in Mike, L as in Lima, 8.
[AGENT][NEUTRAL] Please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Uh, the patient's name is [PII].
[CUSTOMER][NEUTRAL] And last name is uh [PII]. And the date of birth is
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and what's the date of service and bill charges on the claim you're calling about?
[CUSTOMER][NEUTRAL] Uh, the date of service is [PII] and the bill amount is $882 and even.
[AGENT][NEUTRAL] OK, thank you. And one moment, please. And you said that was for [PII]?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, I'm not showing that
[CUSTOMER][NEUTRAL] OK, may I get your name, please?
[AGENT][NEUTRAL] Um, my name is [PII]. Um, it's spelled [PII] and my last initial is [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, I'm not showing a claim on file with that date of service.
[CUSTOMER][NEUTRAL] OK, sure. Uh,
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, OK. What was the effective on the termination date of the patient?
[AGENT][NEUTRAL] OK. And just let me advise you that verification of coverage does not guarantee payment of claims. The effective effective date on this policy was [PII].
[AGENT][NEUTRAL] That's the effective date and this policy expired on [PII].
[CUSTOMER][NEUTRAL] OK. So the policy is
[CUSTOMER][NEUTRAL] Active for the data service, right.
[AGENT][NEUTRAL] Yes, the policy was active on the date of service.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] What was the timely filing limit to submit the claim?
[AGENT][NEGATIVE] There's no timely filing limit.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. What was the mailing address?
[AGENT][NEUTRAL] The mailing address is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And that's in [PII].
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And the zip code is [PII].
[CUSTOMER][NEUTRAL] Just uh payroll
[CUSTOMER][NEUTRAL] [PII], right?
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] OK, it is [PII].
[CUSTOMER][NEUTRAL] [PII], right?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] OK, what was the payer ID?
[AGENT][NEUTRAL] The payer ID is 60801.
[CUSTOMER][NEUTRAL] 0801. OK.
[CUSTOMER][NEUTRAL] Uh, may I get a call reference number?
[AGENT][NEUTRAL] Yeah, the reference number is my name and today's date. My name is Evie. Um it's spelled [PII] My last initial is [PII] and today's date. Is there anything else that I can assist you with?
[CUSTOMER][NEUTRAL] OK. Uh, wait a moment. Uh, did you not able to phone the member for the previous date of, uh, previous member ID?
[AGENT][NEUTRAL] That's correct. I was unable to find that member.
[CUSTOMER][NEUTRAL] OK, wait a moment. I will check that.
[CUSTOMER][NEUTRAL] Hold a moment.
[CUSTOMER][NEUTRAL] OK. It was an American plan administrator.
[AGENT][NEUTRAL] Excuse me. What's your question?
[CUSTOMER][NEUTRAL] Uh, this insurance is American Plan administrator.
[AGENT][NEUTRAL] No, this is American Public Life.
[CUSTOMER][NEUTRAL] OK, sure.
[CUSTOMER][NEUTRAL] OK. Sure, sure.
[CUSTOMER][POSITIVE] OK. Thank you, [PII], and have a wonderful day. Bye-bye. Thanks for staying.
[AGENT][NEUTRAL] You do the same, [PII]. You as well. Thank you for calling ATL. Mm bye.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] So