AccountId: 011433970860
ContactId: dd36de67-df49-4d28-999a-a6443a1b7818
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 313140 ms
Total Talk Time (AGENT): 149676 ms
Total Talk Time (CUSTOMER): 76553 ms
Interruptions: 1
Overall Sentiment: AGENT=0.8, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/21/dd36de67-df49-4d28-999a-a6443a1b7818_20250521T18:52_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Did you say [PII] or [PII]?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I'm calling regarding a claim.
[AGENT][NEUTRAL] OK, I could check on that claim for you. uh, [PII], can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and was this for your individual policy or are you with a provider?
[CUSTOMER][NEUTRAL] Provider.
[AGENT][NEUTRAL] OK, do you have that policy number?
[CUSTOMER][NEUTRAL] D for Delta 46701869.
[AGENT][NEUTRAL] OK, so [PII], that is not one of our policy numbers. That is through, uh, they're called 90 degree benefits. I can give you their information and transfer you to them, or if you have the member's social, I can see if they do have a policy with us.
[CUSTOMER][NEUTRAL] Um, I don't have their social, but 90 Degree is the one who transferred me over to you guys.
[AGENT][NEUTRAL] Oh my goodness OK oh that's confusing and frustrating. I'm sorry, so they, they might have one with us, um, that's just not a policy number I can search with um if you don't have the social, the only other way I can search for this number is by their first and last name if you wouldn't mind spelling that out for me please.
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right. The first name is [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And the last name is [PII]
[AGENT][NEUTRAL] OK all right thank you one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, and what state does this member live in?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Alright, and then do you have the date of birth for this number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Awesome. OK, so I did find their poli this was for medical, correct?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK, yes, I did find that policy um whenever you're ready I can go ahead and give you that policy number that uh he has with us.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so that is 02.
[AGENT][NEUTRAL] 35.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 9039.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, thanks, [PII].
[AGENT][NEUTRAL] Of course alrighty and what was the date of service for this claim?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] That was [PII] and then uh do you have that billed amount?
[CUSTOMER][NEUTRAL] $320.
[AGENT][NEUTRAL] 320 OK thank you one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Is this with, um, is it NHMG Primary care clinics?
[CUSTOMER][POSITIVE] You got it.
[AGENT][POSITIVE] OK, awesome. Give me just a moment.
[AGENT][NEUTRAL] OK, so for this claim it does look like um we are still waiting for it's uh in a pending status. I can go ahead and give you that claim number um we are waiting for um information regarding eligibility from this member's employer so once we have that information then we'll be able to continue processing.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Employer
[AGENT][NEUTRAL] I can also uh fax you the EOB if you need that.
[CUSTOMER][NEUTRAL] Uh, no, we, we'll just have to wait. That's fine.
[AGENT][NEUTRAL] OK, sure, did you want that claim number?
[CUSTOMER][POSITIVE] OK, I'm ready for the client number.
[AGENT][NEUTRAL] Yes, that is 353-069-9.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] And is it a specific time frame that you guys allowed an employee to get back with you?
[AGENT][NEUTRAL] Unfortunately, no unfortunately not um it's just one of those things as soon as we got that information we'll be able to continue processing it's just as soon as that employer is able to get that information to us.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, and is there a reference number for today's call?
[AGENT][NEUTRAL] It would be my first name, last initial, and today's date. Uh, so my last initial is [PII] And was there anything else I could help you with, Andre?
[CUSTOMER][NEUTRAL] That'll be it [PII].
[AGENT][POSITIVE] Alright well thanks for giving us a call. I hope you have a great rest of your day.
[CUSTOMER][NEUTRAL] You do the same.
[AGENT][POSITIVE] Thank you. Bye bye.
[CUSTOMER][NEUTRAL] Bye.