AccountId: 011433970860
ContactId: e5e910c8-2f39-40e0-97de-21c333b2b244
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 238740 ms
Total Talk Time (AGENT): 126090 ms
Total Talk Time (CUSTOMER): 68538 ms
Interruptions: 1
Overall Sentiment: AGENT=1.6, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/07/e5e910c8-2f39-40e0-97de-21c333b2b244_20250107T21:49_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hello [PII], and my name is [PII]. I'm calling from a provider's office to check eligibility and I would say confirmed claim status, but I think we already submitted the claim to the incorrect claims stress. So basically I'm calling to verify eligibility and get the correct claim stress information.
[AGENT][NEUTRAL] OK, and you said your name is [PII], is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, and you said that you're needing to verify eligibility and also to verify the correct claims mailing address?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Yes ma'am, I can help you with those things, and [PII], what is a good call back number for you please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you. And the member's policy number, please.
[CUSTOMER][NEUTRAL] OK. That is going to be.
[CUSTOMER][NEUTRAL] 02551202
[AGENT][NEUTRAL] OK, thank you. One moment.
[AGENT][NEUTRAL] And any information [PII] that I provide for you will be a verification of benefits and not a guarantee of payment. What is your patient's name please and their date of birth?
[CUSTOMER][NEUTRAL] Um, yes, this is for Mc Xavion [PII], [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] So I do show that he is a subscriber on this, excuse me, on this limited benefit plan and the policy is active.
[AGENT][NEUTRAL] With an effective date of [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And excuse me, the correct mailing address for claims, they would be sent to IMA.
[AGENT][NEUTRAL] And that is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] The zip code is [PII].
[CUSTOMER][NEUTRAL] OK, and that's what it has on the back of the card. I'm not sure why whoever entered this in here did it the way they did, but we will get this updated and get a claim out to the right claims address.
[AGENT][NEUTRAL] OK, and, uh, would you like their payer ID as well? But if you have the ID card, it should be on there 64556.
[CUSTOMER][NEUTRAL] Yes, I, I, I do have it. I just wanted to confirm, I guess, I guess I basically just wanted to confirm someone else was wrong and, and this card is right. Um, may I get your name again and a call reference number?
[AGENT][NEUTRAL] Hi.
[AGENT][NEUTRAL] Yes, ma'am. Uh, well, one thing first, um, we do have a portal Katrina, that once the claim has been processed, you all should be able to access the EOB and status from, and that portal website is secured.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, I'll check into that too to see if I can register.
[AGENT][NEUTRAL] And for your, OK. Sure. And you will not be able to find anything obviously until the claim has been processed, but um
[AGENT][POSITIVE] If you need any help, you can call us back. We're setting that up.
[AGENT][NEUTRAL] And then you would use my name and today's date for your call reference number.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, alright, thank you so much I appreciate your time.
[AGENT][POSITIVE] All right. Well, you're certainly very welcome. So if that's all that I can help you with, thank you for calling APL and I hope that you have a very nice rest of your day.
[CUSTOMER][POSITIVE] Thank you you as well bye bye.
[AGENT][POSITIVE] Yes, ma'am. Thank you. Bye bye.