AccountId: 011433970860
ContactId: c8ba1695-eb37-40f2-b64a-7702df5b2429
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 322540 ms
Total Talk Time (AGENT): 102030 ms
Total Talk Time (CUSTOMER): 158478 ms
Interruptions: 2
Overall Sentiment: AGENT=0.7, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/09/c8ba1695-eb37-40f2-b64a-7702df5b2429_20250109T13:22_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hello, good, good morning, [PII]. Uh, my name is [PII] calling from provider office regarding about the class status, [PII].
[AGENT][NEUTRAL] OK, you're you're calling regarding.
[CUSTOMER][NEUTRAL] About the claims to the general claims that's looking for the general claims status.
[AGENT][NEUTRAL] Claim, OK, a claim status, the policy number, [PII]?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] The policy number 01666016 M as in Mary L as in Lima 8.
[AGENT][NEUTRAL] What's a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And what is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Sure. Uh the first name is [PII], and the last name is [PII] and date of birth is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you for verifying the information and you said that you're wanting to check a claim status correct?
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][POSITIVE] Yeah definitely [PII].
[AGENT][NEUTRAL] OK, we can assist with that information. What is the date of service in charge?
[CUSTOMER][NEUTRAL] Yeah, it's gonna be [PII] and the bill amount is $91.80.
[AGENT][NEUTRAL] 18 or 80.
[CUSTOMER][NEUTRAL] 880.
[AGENT][POSITIVE] 80. OK, thank you.
[CUSTOMER][POSITIVE] No problem.
[AGENT][NEUTRAL] OK, [PII], let me give you the current policy number.
[AGENT][NEUTRAL] For that data service?
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] It's 246.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 4978.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And I checked the date of service [PII] and I don't show that we've received that claim at this time.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, the claim is not still on file, am I right?
[AGENT][NEUTRAL] The claim is not on file.
[CUSTOMER][NEUTRAL] No, no, uh, data service [PII].
[AGENT][NEGATIVE] The claim is not on file. We've not received it.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Not receive it. So, uh, can you, you're saying that the policy number is 246-4978. Is it correct?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] This is the correct policy number, am I right?
[AGENT][NEUTRAL] For that date of service, yes.
[CUSTOMER][NEUTRAL] So what about the policy with uh the policy number which I have given you?
[AGENT][NEUTRAL] It turned in 2022.
[CUSTOMER][NEUTRAL] 01
[CUSTOMER][NEUTRAL] OK, OK, OK, OK. And can you please verify me the effective that.
[CUSTOMER][NEUTRAL] Member eligibility.
[AGENT][NEUTRAL] Policy effective date is [PII]. This policy is active.
[CUSTOMER][NEUTRAL] OK, so.
[AGENT][NEUTRAL] And do you need the claims mailing address or fax number?
[CUSTOMER][NEUTRAL] Yeah, definitely. Yeah, mailing address.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, uh, [PII], I just still have uh one more question. So do I, do I need to resubmit the claim because we have already transmitted the claim on [PII]. So do I need to resubmit the claim or do we need to still wait for this, uh, the claim status?
[AGENT][NEUTRAL] You said you submitted it in September or December?
[CUSTOMER][NEUTRAL] Yeah, as far as check it, it's showing uh transmitted to that is on [PII].
[AGENT][NEUTRAL] Yeah, if we've not received it I I mean it's up to you but I would resubmit it we should have received it by now. Where did you how did you send it?
[CUSTOMER][NEUTRAL] Uh, so I think to EFT.
[CUSTOMER][NEUTRAL] Actually we didn't have that all the information for that one.
[AGENT][NEUTRAL] You submitted it electronically?
[CUSTOMER][NEUTRAL] So, and what is the uh pay?
[CUSTOMER][NEUTRAL] No idea, uh, sorry for that, [PII]. So, OK, let us just forget about it and can you please verify me the payer ID?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] 60801.
[CUSTOMER][NEUTRAL] 60801. So that means I can resubmit the claim or do I need to.
[CUSTOMER][NEGATIVE] Still need to wait for some time because it was transmitted on, it was recently like still not yet 30 days.
[AGENT][NEUTRAL] OK, I guess I need to verify how did you submit it? Was it and what address did you send it to or where did you send it?
[CUSTOMER][NEUTRAL] No, actually, uh, [PII], I'm sorry, I apologize for that, we didn't have all the information regarding about that.
[AGENT][NEUTRAL] OK, then you would need to resubmit it if you have the incorrect information.
[CUSTOMER][POSITIVE] OK, sure, thank you so much and the call reference number, [PII].
[AGENT][NEUTRAL] You're gonna use my name in today's date, [PII] and any other questions, [PII] I can help out with today?
[CUSTOMER][POSITIVE] OK, no problem. Uh, thanks for asking. I appreciate for your time, [PII]. Have a wonderful rest of day, OK? Take care.
[AGENT][POSITIVE] You're welcome.
[AGENT][POSITIVE] Thank you for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] OK, you too, bye.