AccountId: 011433970860
ContactId: c9aa81e9-cc3d-4a7f-9ce4-ba5e2223ab07
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 319209 ms
Total Talk Time (AGENT): 126851 ms
Total Talk Time (CUSTOMER): 139731 ms
Interruptions: 1
Overall Sentiment: AGENT=0.8, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/21/c9aa81e9-cc3d-4a7f-9ce4-ba5e2223ab07_20250521T15:13_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] Good morning, [PII]. My name is [PII] and first initial of my last name is [PII], calling from provider's office to check on a claim.
[CUSTOMER][NEUTRAL] How are you doing today?
[AGENT][POSITIVE] I'm doing well. How are you today, [PII]?
[CUSTOMER][POSITIVE] Yeah, I'm doing great. Thank you for asking.
[AGENT][NEUTRAL] You're welcome. And may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Uh, sure. The good callback number is [PII]. It's a direct line.
[AGENT][NEUTRAL] Thank you. And how many claims do you have in total today?
[CUSTOMER][NEUTRAL] Mm, yeah, totally I'm having only one claim.
[AGENT][NEUTRAL] OK, may I have the member's um policy number?
[CUSTOMER][NEUTRAL] Sure. The policy number is gonna be 1356005 M as in Mike L as in Lima 8.
[AGENT][NEUTRAL] Thank you. And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Mm, yeah, the member name is [PII] [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And may I have the date of service and the total bills for the claim?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, sure. The date of service is [PII] with the total charged amount of $190 even.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And that was [PII]?
[CUSTOMER][POSITIVE] Yeah, exactly.
[AGENT][NEUTRAL] OK, so hold on one sec. So this particular policy number is no longer active. It was effective from [PII]. There is an active policy number.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, and that is 21.
[CUSTOMER][NEUTRAL] 2019
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] Yeah, actually, in the patient ID card, uh,
[CUSTOMER][NEUTRAL] It seems.
[CUSTOMER][NEUTRAL] There is another ID is um.
[AGENT][NEUTRAL] It's just an old card.
[CUSTOMER][NEUTRAL] Uh, yes, it ends with the
[CUSTOMER][NEUTRAL] 7. And this is for in hospitals benefit number. This policy number is
[AGENT][NEUTRAL] Right, so the, the information you have is no longer valid. I'm gonna give you the correct information.
[CUSTOMER][POSITIVE] Uh yes, I'm ready for that. Go ahead.
[AGENT][NEUTRAL] So the active policy number is 214.
[AGENT][NEUTRAL] 8363.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And this policy has been active since [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And I'm gonna search the policy for, um, for the claim. Hold on one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] But still, I don't see a claim on file for [PII].
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK, because we use the mm different member ID uh on the claim form.
[CUSTOMER][NEUTRAL] Mm, I think.
[AGENT][NEUTRAL] Well, we didn't, even the old ID we didn't, um, we hadn't received it. If you do put the old ID on there though, it would, we would and we receive it, we'll still um process it under the active policy, but we haven't received it on either.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh OK and.
[CUSTOMER][NEUTRAL] Yep, uh, could you please spell out your name for me?
[AGENT][NEUTRAL] Sure, so my name is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, [PII], and
[CUSTOMER][NEUTRAL] Could you please provide me the mailing address for submitting the claim?
[AGENT][NEUTRAL] Sure. It's [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Zip code is [PII], I'm sorry.
[AGENT][NEUTRAL] Oh, I did, I said that correctly. [PII]. My apologies.
[CUSTOMER][NEUTRAL] OK. [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] [PII]. OK. Thank you so much for the information, [PII], and
[CUSTOMER][NEUTRAL] May I know the pay ID number of the insurance?
[AGENT][NEUTRAL] Sure. It's 60801.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK. Thank you so much for the information, [PII]. And can I get the reference number for today's call?
[AGENT][NEUTRAL] Sure, so there's no call reference number, but you can use my name in today's date.
[CUSTOMER][POSITIVE] OK, and, yep, I'm done with this space and then that's all for today. Thank you for assisting me. I hope you have a wonderful.
[CUSTOMER][NEUTRAL] Day as well.
[AGENT][POSITIVE] Thank you. You also, and thanks for calling APL.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Bye bye.
[CUSTOMER][NEUTRAL] Mhm bye bye, be safe.
[AGENT][POSITIVE] Thank you, you also. Bye-bye.
[CUSTOMER][NEUTRAL] 16.
[CUSTOMER][NEUTRAL] Mhm.