AccountId: 011433970860
ContactId: d97204e9-5edb-4930-a52c-2ac22731db3c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 491709 ms
Total Talk Time (AGENT): 198898 ms
Total Talk Time (CUSTOMER): 135581 ms
Interruptions: 2
Overall Sentiment: AGENT=1.1, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/25/d97204e9-5edb-4930-a52c-2ac22731db3c_20250425T13:04_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, [PII]. My name is [PII] and I'm calling you from the provider's office. And I'm looking for claim status.
[AGENT][NEUTRAL] OK, [PII], you're needing to check claim status, is that correct?
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] Yes, I can help you with that, [PII], and what is your callback number?
[CUSTOMER][NEUTRAL] Callback number is [PII]. It's a direct line. There's no extension.
[AGENT][NEUTRAL] Thank you and [PII], how many claims do you have to check status on today?
[CUSTOMER][NEUTRAL] I have only one claim for one patient.
[AGENT][NEUTRAL] OK, and I can help you with that. What is the member's policy number, please?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Mhm. And the policy number I do have which is
[CUSTOMER][NEUTRAL] Mm, let's 690. OK. And the policy number, it's 02496874.
[AGENT][NEUTRAL] OK, thank you one moment please, and let me get the member's information all pulled up.
[CUSTOMER][NEUTRAL] Mhm. Sure.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And any information that I do provide for you today, [PII] would be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth?
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm. The patient name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK, so I heard you to say that the, the, the policy number was 02496874. Is that correct?
[CUSTOMER][NEUTRAL] Oh no, 72 at the end.
[AGENT][NEUTRAL] OK, so just a moment for me to locate that member's information.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Well I
[AGENT][NEUTRAL] OK, bear with me just a moment, please.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Sure, [PII].
[AGENT][NEUTRAL] I had to reopen one of my screens, [PII] said it was taking a moment.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um
[AGENT][NEUTRAL] OK, and I'm so sorry if you could please re verify the member's name and date of birth.
[CUSTOMER][NEUTRAL] It's [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Uh-huh.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] And
[AGENT][NEUTRAL] And what is the members, um, I'm sorry, what is the data service in total bill amount?
[CUSTOMER][NEUTRAL] It's [PII], uh, [PII].
[CUSTOMER][NEUTRAL] And the bill charge is $353.40.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, now, um.
[AGENT][NEUTRAL] Let me double check.
[CUSTOMER][NEUTRAL] Sure, [PII].
[AGENT][NEUTRAL] OK, so for this policy there is no claim on file for this member for this data service this policy was actually not active.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] For your data service.
[AGENT][NEUTRAL] So let me see if there's another policy.
[CUSTOMER][NEUTRAL] And may I know the mhm.
[AGENT][NEUTRAL] Yes, this policy has an effective date and a term date of [PII].
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] It's like it was never active, so give me just a moment to see if there's another policy.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And there he is, so I'll need to give you a different policy number.
[CUSTOMER][NEUTRAL] We
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The correct policy number for this member.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] will be 02569076.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And just one moment on that.
[AGENT][NEUTRAL] And it has an effective date of [PII].
[CUSTOMER][NEUTRAL] Yeah. Mhm.
[AGENT][NEUTRAL] And let me get that information pulled up.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] You
[AGENT][NEUTRAL] And one more time, [PII], any information that's provided would be a verification of benefits and not a guarantee of payment. You did say the date of service is going to be [PII]. Is that correct?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, and we also do not have a claim for this member for that data service.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] OK. And just want to verify the claim mailing address we have on file. Uh, whenever you're ready, I can go ahead and verify. OK. It's [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Go ahead.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] [PII], uh, let me just check. [PII], right?
[AGENT][POSITIVE] Yes, sir, that is correct.
[CUSTOMER][POSITIVE] OK, [PII], sounds great thank you so much.
[AGENT][NEUTRAL] And, and, and [PII], because this is a supplement to the primary insurance, um, we will also have to receive a copy of the primary insurance company's explanation of benefits along with this claim.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And then once the claim has been processed, we do have a portal that you should be able to check claim status in and the website for our portal is located at [PII].
[CUSTOMER][NEUTRAL] Oh yes.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][POSITIVE] OK, sounds good.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And is there anything else that I can help you with today?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh no, that's all from my end, and I'm done with all my questions to you. You can just proceed with the reference number of this call.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right.
[AGENT][POSITIVE] Yes, sir, you will actually use my name along with today's date.
[CUSTOMER][POSITIVE] Sounds great. Thank you so much, [PII], and have a wonderful day ahead.
[AGENT][POSITIVE] Well, you, uh, thank you so much, [PII]. I hope you do too, and I hope you have a great weekend as well.
[CUSTOMER][POSITIVE] You soon. Bye-bye. Take care.
[AGENT][POSITIVE] Thank you, you too. Bye bye.
[CUSTOMER][NEUTRAL] Mhm.