AccountId: 011433970860
ContactId: d0121bc1-44a8-44ac-af76-374e75388605
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 323019 ms
Total Talk Time (AGENT): 118925 ms
Total Talk Time (CUSTOMER): 121754 ms
Interruptions: 3
Overall Sentiment: AGENT=0.6, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/24/d0121bc1-44a8-44ac-af76-374e75388605_20250324T17:08_UTC.wav
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[AGENT][NEUTRAL] Hi this is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from provider's office and I'm looking on a team status.
[AGENT][NEUTRAL] Sure, [PII], I can assist you with that. Can I have a callback number for you and that policy number?
[CUSTOMER][NEUTRAL] Yeah. Our callback number is [PII] and it's a direct line. And the member's ID is going to be 02497688.
[AGENT][NEUTRAL] Can you verify that patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] The member's name is uh
[CUSTOMER][NEUTRAL] [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] And what is the date of service that you're calling to check the status of a claim for?
[CUSTOMER][NEUTRAL] Date of service is on [PII] and the bill amount of $1,198 even.
[AGENT][NEUTRAL] This policy terminated.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK. When was the policy terminated?
[CUSTOMER][NEUTRAL] [PII]. OK. Is there any
[AGENT][NEUTRAL] And what was your bill amount?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] $1,198 even.
[AGENT][POSITIVE] 2239. Thank you.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] 2239.
[AGENT][NEUTRAL] If this claim was the claim was received on [PII]. It was processed [PII]. There was no payment because the the services were received after the policy termination date, which the policy was effective from [PII].
[CUSTOMER][NEUTRAL] So, the number is not active for the date of service.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you so much for that. And what was your name again?
[AGENT][NEUTRAL] My name is [PII] and today's date as a reference.
[CUSTOMER][NEUTRAL] Oh, OK. Can you just give me a minute? I'll just check is there any other claims from my side for the different number?
[CUSTOMER][NEUTRAL] Yeah, actually, upon checking here, there is one more claim from my side for the different number. Could you help me with that?
[AGENT][NEUTRAL] Sure, give me one moment.
[CUSTOMER][NEUTRAL] Yes, OK.
[AGENT][NEUTRAL] And I apologize, what was your name?
[CUSTOMER][NEUTRAL] My name is [PII]
[AGENT][NEUTRAL] Thank you, [PII]. Would you like that claim number for this member or do you already have it?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh, actually, I have the policy number which is 02462236.
[AGENT][NEUTRAL] No, I'm talking about the, the prior, not the new one, but the prior one that we just working on.
[CUSTOMER][NEUTRAL] For the previous one, I don't have a claim number. If you have a claim number, could you please provide me?
[AGENT][NEUTRAL] So the claim number for the member that you was calling about before the 2nd 1?
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] It is 35
[CUSTOMER][NEUTRAL] The first one was uh for [PII].
[AGENT][NEUTRAL] Yes, it's 356-223-9.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] 356-2239. Mhm.
[CUSTOMER][NEUTRAL] So that is the claim number, OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] What is the next policy number?
[CUSTOMER][NEUTRAL] Can we go for the next number?
[CUSTOMER][NEUTRAL] Which is 02462-236. M as in Mike, L as in Lima, number 8.
[AGENT][NEUTRAL] Can you verify the patient's name and date of birth?
[CUSTOMER][NEUTRAL] The member's name is [PII]. Date of birth is on [PII].
[AGENT][NEUTRAL] And what is your date of service?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And what's your total bill amount?
[CUSTOMER][NEUTRAL] $14,740 even.
[AGENT][NEUTRAL] The claim was received [PII]. It was processed [PII]. There was no payment made on this claim because we're requesting the EOB to be sent in from the primary insurance company.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. Can I have your fax number?
[AGENT][NEUTRAL] The first number is.
[AGENT][NEUTRAL] [PII] that's [PII] attention claims department.
[CUSTOMER][NEUTRAL] OK. Can I
[CUSTOMER][NEUTRAL] OK. May I know what is the claim number?
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] 3558928
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][POSITIVE] OK, thank you so much for Shylight. It was nice talking to you and have a great day.
[AGENT][POSITIVE] Thanks for calling APL. Have a great day as well. Goodbye, [PII].
[CUSTOMER][NEUTRAL] OK. OK. Just a second. Sorry for that. Just a second.
[CUSTOMER][POSITIVE] OK, nothing from my side, and thank you so much for that. Have a nice day.
[AGENT][POSITIVE] You're welcome. Thanks for calling APL. Have a good day.