AccountId: 011433970860
ContactId: cbe884ae-810c-48c2-b345-74b851ab713b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 316980 ms
Total Talk Time (AGENT): 152032 ms
Total Talk Time (CUSTOMER): 111234 ms
Interruptions: 1
Overall Sentiment: AGENT=0.4, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/16/cbe884ae-810c-48c2-b345-74b851ab713b_20250416T16:40_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey, [PII], this is [PII].
[CUSTOMER][NEUTRAL] I need to follow up on some claims that we're waiting to see if the um eligibility is in place.
[AGENT][NEUTRAL] Sure, I could check those claims for you. Uh, [PII], can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And then do you have that policy number?
[CUSTOMER][NEUTRAL] Um, it says it's 2586493.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Hold on.
[CUSTOMER][NEUTRAL] That's the policy number it says it's being processed on, so the same as the person's ID.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, uh, what was the name and date of birth for the member?
[CUSTOMER][NEUTRAL] Ea the urge, [PII].
[AGENT][NEUTRAL] OK, thank you for verifying that. I know you said that there were a few clients we needed to look at are they all for the same member?
[CUSTOMER][NEUTRAL] The same member and it looks like it's one hospital like visit from [PII] through [PII]. I'm sorry, of [PII].
[AGENT][NEUTRAL] OK, that was [PII], correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, um, so is that a single claim do you know? Or were there a few within that time period?
[CUSTOMER][NEUTRAL] Let's see if I can see, it looks like it's one claim and it might be marked under [PII].
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] When I look at the invoice it says [PII] for 200, well, never mind.
[AGENT][NEUTRAL] Sure, do you
[CUSTOMER][NEUTRAL] $1930?
[AGENT][NEUTRAL] No
[AGENT][NEUTRAL] 1930. OK. Alrighty. Give me just a moment, let me see if I can find this.
[CUSTOMER][NEGATIVE] Weird.
[CUSTOMER][NEUTRAL] It looks like every day might be $200. That makes sense.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I don't know, this is strange.
[CUSTOMER][NEUTRAL] You tell me what you see.
[AGENT][NEUTRAL] OK, I do see several.
[CUSTOMER][NEUTRAL] Cause now I'm seeing just one that says $200 so I'm confused.
[AGENT][NEUTRAL] Yeah, OK, I'm seeing quite a bit, um, let's do this, uh, [PII], do you have uh the provider's tax ID?
[CUSTOMER][NEUTRAL] There it is, OK, uh, yes, 202-749055. I finally got it to open, so it's like 200 bucks almost every day except for the initial one.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, OK, so I do see.
[CUSTOMER][NEUTRAL] 3:30.
[AGENT][NEUTRAL] Again, several claims, um, so I might just look at all of these from this provider, uh, within this date of this frame if that's OK.
[CUSTOMER][NEUTRAL] OK, mhm.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII] is what I see.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Oh, I see. OK, um.
[AGENT][NEUTRAL] So for these this is what we were needing clarification on um because we were awaiting the um.
[AGENT][NEUTRAL] Eligibility response from the employer OK.
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] OK. I'm just gonna kinda go down the list here, um, cause there are quite a bit. So this was um [PII] Associates, correct?
[CUSTOMER][POSITIVE] Correct, mhm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] So,
[AGENT][NEUTRAL] From what I am seeing.
[AGENT][NEUTRAL] I believe we did try to reprocess, uh, however, we are still awaiting for that eligibility information from the employer.
[CUSTOMER][NEUTRAL] OK, um, so should I give it another 1 week or 2 weeks? What do you think?
[AGENT][NEUTRAL] Honestly it's I know this is difficult because it really does depend on the well it depends on the employer right so if you, the only thing that would.
[CUSTOMER][NEGATIVE] Because if they reject it, then we got bigger problems.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] Speed it along is if you wanted to reach out to the patient and, you know, tell them to kinda call their HR and tell them to get back with. That's really um it's, it's kind of in their uh their court right now.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] That's actually a great idea.
[AGENT][NEUTRAL] Yeah, otherwise I mean you know I don't know we can keep sending notifications but sometimes it might just take that.
[CUSTOMER][NEUTRAL] OK, I could do that.
[CUSTOMER][NEUTRAL] It's easier for them, yeah. Alright, what was your name again?
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] I don't know why I didn't write that down. And then do you have a reference number for me?
[AGENT][NEUTRAL] Sure, that would just be my first name, last initial, and today's date and so my last initial is A. Was there anything else I could help you with here?
[CUSTOMER][NEUTRAL] No, that's pretty much it. I'm gonna go do your recommendation.
[AGENT][NEUTRAL] All right.
[AGENT][POSITIVE] Sounds good. All right. I hope you have a great rest of your day. Thanks for giving us a call.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] Bye.
[AGENT][POSITIVE] Thank you. Bye bye.