AccountId: 011433970860
ContactId: cb637882-bf84-4df2-8765-5f1bd1cedf1a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 302470 ms
Total Talk Time (AGENT): 171371 ms
Total Talk Time (CUSTOMER): 88260 ms
Interruptions: 0
Overall Sentiment: AGENT=1.7, CUSTOMER=1.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/24/cb637882-bf84-4df2-8765-5f1bd1cedf1a_20250224T16:18_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Good morning [PII]. This is [PII] calling from Bevita Hospital, uh, to check the status, please.
[AGENT][NEUTRAL] OK. And you said your name is [PII], is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes, ma'am, and you're needing to check claim status, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Yes, I can help you with that. And [PII], what is your callback number, please?
[CUSTOMER][POSITIVE] Yes, I can do with that.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And the member's policy number, please?
[CUSTOMER][NEUTRAL] 01609374 ML 7.
[AGENT][NEUTRAL] OK, thank you one moment while I get the member's information pulled up.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] OK, and I, any information that I do provide will be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth?
[CUSTOMER][NEUTRAL] Uh, [PII] DOB [PII].
[AGENT][POSITIVE] Thank you. [PII], what was the year?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]. OK, thank you. And what is the data service and total bill amount for him?
[CUSTOMER][NEUTRAL] That's.
[CUSTOMER][POSITIVE] OK, give me a second. I have it here. I lost. I'm so sorry. OK.
[AGENT][NEUTRAL] Mhm, that's OK.
[CUSTOMER][NEUTRAL] It's a 2142 2 1824.
[AGENT][NEUTRAL] And the total bill amount?
[CUSTOMER][NEUTRAL] $91,035.90.
[AGENT][NEUTRAL] One moment please.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] OK, now, [PII], I need to give you a different policy number because the policy number you gave me is an old policy that was active from 101 of 18.
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] To 101 of 2019.
[CUSTOMER][NEUTRAL] Mhm. Oh.
[AGENT][NEUTRAL] The policy number that was active for the date of service that you're inquiring on?
[AGENT][NEUTRAL] was 1791904.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And give me a moment to get that information pulled up to see if we received the claim on there, so just one moment.
[CUSTOMER][POSITIVE] OK. Thank you. OK.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] OK, and we do not have a claim on file for him on this supplemental policy for that data service.
[CUSTOMER][NEUTRAL] Could you give me the address to uh to file a claim, please? Or to send the claim?
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Hm.
[AGENT][NEUTRAL] That is [PII].
[AGENT][NEUTRAL] And the zip code is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]. I, I'm so sorry, what?
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] Yes, ma'am. Uh-huh.
[AGENT][NEUTRAL] No, that's OK. That is correct. [PII].
[CUSTOMER][POSITIVE] Great.
[CUSTOMER][NEUTRAL] Right
[AGENT][NEUTRAL] Now, because this is a supplemental policy to his primary insurance, we will also need to receive a copy of his primary insurance company's explanation of benefits as well.
[CUSTOMER][POSITIVE] OK, perfect. You'll be.
[AGENT][NEUTRAL] And then once primary EOB and then once we have processed our claim [PII] we do have a portal in which you should be able to check claim status and by going to secured.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Do I need to register?
[AGENT][NEUTRAL] You would, it's a self-registering portal, you would just create the profile under I am a medical or dental provider.
[AGENT][NEUTRAL] And again, once the claim has been processed, you should be able to access that from there.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, perfect. And uh [PII], may I have the reference number for this call?
[AGENT][POSITIVE] Yes ma'am, you would, you actually use my name along with today's date.
[CUSTOMER][POSITIVE] Perfect. OK. Thank you so much for this information.
[AGENT][POSITIVE] Well, you are certainly very welcome. And is there anything else I can help you with today, [PII]?
[CUSTOMER][POSITIVE] That's it for now. Thank you so much.
[AGENT][POSITIVE] OK, well, you're welcome and thank you again for calling APL. I hope that you have a wonderful day.
[CUSTOMER][POSITIVE] You too. Thank you.
[AGENT][POSITIVE] Yes, ma'am. Thank you too.
[AGENT][NEUTRAL] Bye-bye.
[CUSTOMER][NEUTRAL] OK. Bye.