AccountId: 011433970860
ContactId: e7bc8908-e533-405d-abba-160963f5f5d9
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 356359 ms
Total Talk Time (AGENT): 122937 ms
Total Talk Time (CUSTOMER): 58607 ms
Interruptions: 0
Overall Sentiment: AGENT=0.1, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/13/e7bc8908-e533-405d-abba-160963f5f5d9_20250313T19:12_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII]. My name is [PII]. I'm calling from Retina Group of Florida and I was trying to um create a portal, but it keeps giving me an error message, so I want to check the claim status.
[CUSTOMER][NEUTRAL] For a member.
[AGENT][NEUTRAL] OK. I can help you with that. Now, you, you're trying to register for the group?
[AGENT][NEUTRAL] Or your specific policy.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] For the um the group.
[AGENT][NEUTRAL] Are you a provider or?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] A provider.
[AGENT][NEUTRAL] OK, hold on just a moment, and can I get your um a good callback number just in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you, [PII]. Hold on just a moment.
[AGENT][NEUTRAL] And have you registered before or is this you're, you're just registering first time?
[CUSTOMER][NEUTRAL] Is um
[CUSTOMER][NEUTRAL] I'm, I'm trying to, I'm in step 2 and it's not taking the patient account number.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And what are you listing for the patient's account number?
[CUSTOMER][NEUTRAL] It said go to box 26 on the claim.
[CUSTOMER][NEUTRAL] That's the number I put in.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, let's see.
[AGENT][NEUTRAL] I'm not familiar with the provider section but um I'm mostly.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] I've got instructions here. I'm seeing if I can figure it out.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] OK. And have you already submitted a claim?
[CUSTOMER][NEUTRAL] Yeah, we submitted a claim.
[AGENT][NEUTRAL] OK, and the insured's policy number?
[CUSTOMER][NEUTRAL] Um, her policy number is 01423563.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And are you using uh a CMS 1500 claim form?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] It says to use the.
[AGENT][NEUTRAL] The number that's in box 26.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] OK, let me connect you with our claims department and see if they can help you further, um.
[AGENT][NEUTRAL] Is there anything else I can help you with in customer service before I transfer you to them?
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] Alright thank you [PII] and hold on just a moment let me connect you with him.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] That
[CUSTOMER][NEUTRAL] Bring
[CUSTOMER][POSITIVE] This is easy.
[AGENT][NEUTRAL] Hi, uh, this is [PII] in customer services. How are you?
[CUSTOMER][POSITIVE] I'm good. How are you doing?
[AGENT][NEUTRAL] I'm good. I have a provider on the phone that's trying to check claim status online, but she's having problems, and I, I tried helping her from the guru cards but she still wasn't able to pull anything up. Is that something that y'all help with or?
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Who, who helps with that?
[CUSTOMER][NEUTRAL] Guru cards.
[AGENT][NEUTRAL] With uh she's trying, she's on the online service center trying to check claim status.
[CUSTOMER][NEUTRAL] OK, I can assist her with that. What's the policy number?
[AGENT][NEUTRAL] OK, the policy number is 1423563.
[AGENT][NEUTRAL] And the lady on the phone is [PII], yeah, from Rena Group of [PII].
[AGENT][NEUTRAL] And I've got a callback number.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. What's that number?
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK. OK, you can send her over.
[AGENT][POSITIVE] All right. Thank you, Ay.
[CUSTOMER][POSITIVE] Mhm, thank you.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Thank you for calling