AccountId: 011433970860
ContactId: ccb4755f-04b9-44e2-9443-dbfcbe8d6147
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 293399 ms
Total Talk Time (AGENT): 89902 ms
Total Talk Time (CUSTOMER): 98798 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/27/ccb4755f-04b9-44e2-9443-dbfcbe8d6147_20250527T16:04_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Yes, I, I was calling to check the status of some claims that I had.
[AGENT][NEUTRAL] OK, I can verify claim status for you and your name is?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And Ms. [PII], what is the policy number, please?
[CUSTOMER][NEUTRAL] 02515497
[AGENT][NEUTRAL] OK, thank you. And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] OK, thank you. Give me a moment.
[AGENT][NEUTRAL] And verify your date of birth, mailing address, and the email address, please.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] [PII] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK. And when was the claim submitted? Because the last claim I'm showing was from provider's office for an office visit.
[CUSTOMER][NEUTRAL] Yes, that's probably the one, so it should be [PII].
[AGENT][NEUTRAL] The date of service was [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] I do not sure we received that claim for that data service.
[AGENT][NEUTRAL] The latest claim we received was for [PII].
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Um, hold on one second.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So it should be from Montegris Baptist and Radiology Associate.
[CUSTOMER][NEUTRAL] I have a
[CUSTOMER][NEUTRAL] Text about um a claim number.
[AGENT][NEUTRAL] OK, what's that claim number?
[CUSTOMER][NEUTRAL] 3602592
[AGENT][NEUTRAL] Yes, ma'am. That was for the claim for data service of [PII] and it processed as office visits are not covered per the policy.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Oh, OK. So that one is about um
[CUSTOMER][NEUTRAL] How much was
[CUSTOMER][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] OK. I don't know if that one was just like a doctor's visit, I guess. So how much was it that they were trying to charge for that one?
[AGENT][NEUTRAL] Uh, it looks like a total charge amount of 320.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, um, and then I should have some coming in for the [PII], but I guess you guys just haven't received that yet.
[AGENT][NEUTRAL] Uh, no, ma'am.
[CUSTOMER][NEUTRAL] OK. Um, how long does that typically take?
[AGENT][NEUTRAL] Uh, we wouldn't have that information. It's just when the provider submits it to us.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] You may contact their office to verify when they submit it, but hopefully a couple of days after they submit, but we don't have an exact date on when claims are received.
[CUSTOMER][NEUTRAL] OK, there's not like a window of time of like you should get it within two weeks of the service or whatever.
[AGENT][NEUTRAL] Uh, we wouldn't know. It's whenever the provider, uh, submits the claim to the primary first. They, uh, process it and then send them a claim decision, and then the provider submits to us, so we wouldn't have an idea.
[CUSTOMER][NEUTRAL] That
[CUSTOMER][POSITIVE] OK. Thank you.
[AGENT][NEUTRAL] You're welcome. And is there anything else I can assist you with today, Ms. [PII]?
[CUSTOMER][POSITIVE] No, that's it. Thank you.
[AGENT][POSITIVE] Yes ma'am, thank you for calling APL have a great day.
[CUSTOMER][NEUTRAL] You too.