AccountId: 011433970860
ContactId: cd903ca8-5d14-49bb-a707-a2eb1c0d31a7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 284880 ms
Total Talk Time (AGENT): 83984 ms
Total Talk Time (CUSTOMER): 99496 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/17/cd903ca8-5d14-49bb-a707-a2eb1c0d31a7_20250217T13:31_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, um, I'm calling from a provider's office looking for claim status.
[AGENT][NEUTRAL] Um, yes, ma'am. I can assist you with claim status. Um, first, could I get your name and a good callback number?
[CUSTOMER][NEUTRAL] [PII] and it's [PII].
[AGENT][NEUTRAL] Thank you, [PII]. Now I need the policy number, please?
[CUSTOMER][NEUTRAL] D43301881
[AGENT][NEUTRAL] OK, that's not one of our policy numbers. Do you have the social or I could look the member up by name and date of birth?
[CUSTOMER][NEUTRAL] Let's see if I have social.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Social Security is [PII].
[AGENT][NEUTRAL] And is this medical or dental?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Medical.
[AGENT][NEUTRAL] OK, and please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] OK, I found her in our system. Would you like her policy number?
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] OK. That number is 023.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 473-43.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And what's the date of service and bill charges on the claim you're calling about?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And bill the amount is 384.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] And I'm still waiting on my system. One moment, please.
[CUSTOMER][NEUTRAL] That's OK.
[AGENT][POSITIVE] OK. Thank you.
[AGENT][NEUTRAL] And what are the bill charges again?
[CUSTOMER][NEUTRAL] 384.
[AGENT][NEUTRAL] OK, I'm actually not showing that claim on file. Um, how was it submitted?
[CUSTOMER][NEUTRAL] So according to the notes in our system.
[CUSTOMER][NEUTRAL] Um, they spoke to another rep.
[CUSTOMER][NEUTRAL] And stated claim was received on [PII] denied on 313 as ineligible under plan stated they are for preventative services only stated claim should have been forwarded to part of Plan America Public Life stated she would be sending claim to them now.
[CUSTOMER][NEUTRAL] So we accidentally sent it to the wrong place, but that place is going to forward the claim over to you.
[AGENT][NEUTRAL] OK. Yeah, I apologize. We haven't received the claim.
[AGENT][NEUTRAL] Um, would you like our pair ID and the, or the mailing address?
[CUSTOMER][NEUTRAL] Well it would be timely right now to to submit the claim.
[AGENT][NEUTRAL] Well, there's no timely filing limit under this policy.
[CUSTOMER][NEUTRAL] So,
[CUSTOMER][NEUTRAL] OK, I will take the claim mailing address.
[AGENT][NEUTRAL] OK, the address is [PII].
[CUSTOMER][NEUTRAL] I am a.
[AGENT][NEUTRAL] Yes, ma'am. I am like [PII]
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] And the [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] So that's [PII].
[AGENT][POSITIVE] Yes, ma'am. That's correct.
[CUSTOMER][NEUTRAL] And policy number was 02347343.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, I will send out the claim today then.
[AGENT][NEUTRAL] OK. Is there anything else that I can assist you with?
[CUSTOMER][POSITIVE] Nope, I'm all good thank you so much.
[AGENT][POSITIVE] OK, thank you, [PII] for calling APL. You have a great rest of your day. Mm bye.
[CUSTOMER][NEUTRAL] You too. Bye.
[AGENT][POSITIVE] Thanks.