AccountId: 011433970860
ContactId: e883e0d6-9a70-4313-9cd9-dc807830abcc
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 365230 ms
Total Talk Time (AGENT): 142035 ms
Total Talk Time (CUSTOMER): 115561 ms
Interruptions: 0
Overall Sentiment: AGENT=1.8, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/11/e883e0d6-9a70-4313-9cd9-dc807830abcc_20250411T17:22_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. This is [PII] calling from the provider's office.
[AGENT][POSITIVE] Hi [PII], how may I help you today?
[CUSTOMER][NEUTRAL] I'm looking for the claim status today.
[AGENT][POSITIVE] OK, well, I'll be more than happy to help you with the claim status and how many claims do you have in total today?
[CUSTOMER][NEUTRAL] One claim.
[AGENT][NEUTRAL] All right. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] 008475817.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And that policy number isn't um an APL policy number. Do you have the member's ID card available?
[CUSTOMER][NEUTRAL] Mm, the member's ID card.
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] OK, do you have the member's full social?
[CUSTOMER][NEGATIVE] Sorry, no.
[AGENT][NEUTRAL] OK. What's the member's first and last name?
[CUSTOMER][NEUTRAL] [PII] Is and the date of birth is [PII].
[AGENT][NEUTRAL] Can you spell the last name for me, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you. Hold on one moment.
[AGENT][NEUTRAL] Do you have a claim number?
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] Do you have the claim number?
[CUSTOMER][NEUTRAL] That I have is 00847, uh, the claim number, I don't have the claim number, sorry.
[AGENT][NEUTRAL] It's OK. Hold on one moment.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] So I'm searching with the member's first and last name. Hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And um does he have a middle initial?
[CUSTOMER][NEUTRAL] Yes, [PII].
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK. I don't, I don't have one with the um, OK. Um.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] Let me just, I'll just write them all. Hold on one second.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] And this is a medical claim?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And what's the date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, let me see if this is him. Hold on one moment.
[AGENT][NEUTRAL] OK, so we have a few [PII]. There was only 2 that didn't have a middle initial.
[AGENT][NEUTRAL] The other ones did, but it wasn't a [PII]. So I'm not showing that member. Um, we're gonna need some more information to search for him. If you can, if you can ask the member for their social or if they have their APL card, what their policy certification number is, um,
[CUSTOMER][NEUTRAL] Uh, do you see the member's name with the [PII]?
[AGENT][NEUTRAL] But
[AGENT][NEUTRAL] As I stated, there is no member with the middle initial beginning with [PII]
[AGENT][NEUTRAL] So the other two that did not have
[CUSTOMER][NEUTRAL] OK, then.
[CUSTOMER][NEUTRAL] I guess that is not the middle initial of this member. It's just the first name is [PII] and the last name is Is.
[AGENT][NEUTRAL] So what I'm trying to explain to you is of the [PII] that we have here on file, several had middle initials. The middle initial was not an [PII] The only two, there were 2 more that did not have anything listed for an initial. So I checked on those two, but they have different, different date of birth. So your member, we cannot find what the information that we have. If you can get more information, we can search more the social.
[CUSTOMER][NEUTRAL] Just
[AGENT][NEUTRAL] The full social or if they have a policy certificate number, that's their APL policy number.
[CUSTOMER][NEUTRAL] OK, just a moment. I'm just checking the, in our portal about the members eligibility with the information.
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] So,
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Do you see this member's name is [PII]?
[CUSTOMER][NEUTRAL] It's the first name?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] We do not have your member on file with the information provided.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] The member's date of birth is also the same we have in the eligibility list that is on [PII]. So, but you don't see the members at your end with this information, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Oh, no worries. Thank you so much for your assistance.
[AGENT][POSITIVE] You're very welcome, [PII]. Was there anything else I can help you with today?
[CUSTOMER][POSITIVE] Nothing more. Have a great day.
[AGENT][POSITIVE] You also, thanks for calling APL. Have a great weekend. Bye-bye.
[CUSTOMER][NEUTRAL] You too. Bye-bye.