AccountId: 011433970860
ContactId: d32d4357-45ab-420f-8363-10eced13c222
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 253179 ms
Total Talk Time (AGENT): 128530 ms
Total Talk Time (CUSTOMER): 73067 ms
Interruptions: 2
Overall Sentiment: AGENT=1.5, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/16/d32d4357-45ab-420f-8363-10eced13c222_20250516T13:55_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] Hi, good morning. I'm calling to check the status of a claim.
[AGENT][NEUTRAL] OK, you have one claim that you're needing status for, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Yes, I can help you with that. And who am I speaking with, please?
[CUSTOMER][NEUTRAL] My name is [PII]. My last name initial is [PII].
[AGENT][NEUTRAL] Thank you and [PII], what is your callback number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you and the member's policy number please.
[CUSTOMER][NEUTRAL] The policy is 02262371 M like Mary L like Lima 8.
[AGENT][NEUTRAL] OK, [PII], thank you one moment while I get the member's information pulled up please.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And any information, [PII] that I do provide for you 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] The patient is [PII] and it's [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And what is the date of service and total bill amount for him?
[CUSTOMER][NEUTRAL] The date of service, one moment, that's 4-9-2025 and the total bill amount is 3100 even.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, so you did say the data services for [PII], is that correct?
[CUSTOMER][NEUTRAL] Um, [PII], yep, [PII].
[AGENT][NEUTRAL] OK, yes ma'am, we do not have a claim on file for him for that data service.
[CUSTOMER][NEUTRAL] Oh shoot OK.
[AGENT][NEUTRAL] Now, if you will
[CUSTOMER][NEUTRAL] It's a Medicare crossover.
[AGENT][NEUTRAL] OK. We're not a major medical carrier and this is a supplemental policy to his private healthcare insurance.
[CUSTOMER][NEUTRAL] Or sorry
[AGENT][NEUTRAL] This is not a supplement to Medicare.
[CUSTOMER][NEUTRAL] Sorry, I didn't mean Medicare. I meant Aetna.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Uh-huh, so we've not received the claim from you all at this point, but when you do submit the claim to us for review, [PII], we will also have to have you include a copy of the primary insurance company's explanation of benefits as well.
[CUSTOMER][NEUTRAL] OK, alright, no worries, I'm gonna do that right now because I, it was supposed to cross over from Aetna but I guess it didn't.
[AGENT][NEUTRAL] And then once.
[AGENT][NEUTRAL] OK, and once.
[AGENT][NEUTRAL] No, ma'am, they would not file that with us.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then once the claim has been received and processed by APL we do have a portal in which you should be able to check claim status in and the website for that portal is located at [PII].
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] With a [PII]
[AGENT][NEUTRAL] [PII] put a D on the word [PII].
[AGENT][POSITIVE] [PII].
[CUSTOMER][NEUTRAL] Could you repeat that one more time? Mhm.
[AGENT][POSITIVE] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] OK alright got it thank you.
[AGENT][POSITIVE] All right. Well, you're very welcome, [PII]. Is there anything else I can help you with today?
[CUSTOMER][NEUTRAL] Uh, no, could I just get a reference number for a call today?
[AGENT][NEUTRAL] Yes, ma'am. You would use my name that I gave you along with today's date.
[CUSTOMER][POSITIVE] OK perfect thanks for your help.
[AGENT][POSITIVE] Well, you're very welcome and I hope you have a wonderful weekend and thank you again for calling APL.
[CUSTOMER][NEUTRAL] You too bye bye.