AccountId: 011433970860
ContactId: e4a649ad-24c5-46d9-aac6-ff2bd13bd58d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 221539 ms
Total Talk Time (AGENT): 95856 ms
Total Talk Time (CUSTOMER): 91104 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/11/e4a649ad-24c5-46d9-aac6-ff2bd13bd58d_20250311T17:54_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, yes, I'm calling in regarding a claim for a patient.
[AGENT][NEUTRAL] OK, needing to check on a claim for a patient, is that what you had said? I'm sorry.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] OK, I'm happy to check a claim for you today. What's the patient's policy number?
[CUSTOMER][NEUTRAL] Um, it is 02592977.
[AGENT][POSITIVE] Thank you. And can I grab your first name, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you, [PII].
[AGENT][NEUTRAL] What is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Um, it is [PII] [PII].
[AGENT][NEUTRAL] And then what is the date of service?
[CUSTOMER][NEUTRAL] Uh yes, date of the service is [PII].
[CUSTOMER][NEUTRAL] And the other one is for 218-2025. Uh, the amount is for 337. That's the first claim.
[AGENT][NEUTRAL] And the build the bone?
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] The second one is from [PII] and that's data of service to [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So I did receive an explanation of benefits I believe where it's saying um.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] Um, in the remarks, it says we are waiting information to confirm eligibility from benefit and a card upon receipt of this information, we will continue processing your claim.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So I don't know exactly what you guys mean by that.
[AGENT][NEUTRAL] So benefits in a card is a third party um employer well they're the employer it's a 10 staff agency and uh they're the ones providing benefits to the insured through their employment so we're waiting on verification to make sure they were eligible at the time of service.
[CUSTOMER][NEUTRAL] OK, so you guys are waiting on their employer then correct?
[AGENT][NEUTRAL] Mhm, yeah.
[CUSTOMER][NEUTRAL] OK, do you know for how long that takes to for you guys to get an answer?
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] No, you.
[CUSTOMER][NEUTRAL] Or how they respond?
[AGENT][NEUTRAL] I don't see any response yet because it looks like we're awaiting the same thing uh for data service 21825, so it looks like the communication was sent out for the first claim data service 2 1125 that was sent out on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Or [PII] and then the other claim it was sent out on [PII], so that was just today.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] To the employer then, OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Alright, um, should I contact the patient and let them know they could, um, he could contact his HR department, letting them know that they're requesting this from the insurance?
[AGENT][NEUTRAL] Yeah they can do that to see if maybe they can expedite the process, but with the temp staff agency it's a normal process just to verify eligibility.
[CUSTOMER][POSITIVE] OK, alright, I will let them know then. OK, thank you so much.
[AGENT][POSITIVE] You're welcome, [PII]. Have a good day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye