AccountId: 011433970860
ContactId: ebf7cbc7-c6d1-46cc-a3dd-882a5f31126d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 320420 ms
Total Talk Time (AGENT): 157134 ms
Total Talk Time (CUSTOMER): 82684 ms
Interruptions: 2
Overall Sentiment: AGENT=1.1, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/29/ebf7cbc7-c6d1-46cc-a3dd-882a5f31126d_20250129T14:07_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, yes, this is [PII] with the diabetes Care Center. I'm calling to see if I could get some claim status on a claim.
[AGENT][NEUTRAL] OK, [PII], you're wanting to check one claim status, is that correct?
[CUSTOMER][POSITIVE] Yes, correct.
[AGENT][POSITIVE] Yes, ma'am. I can help you with that. And uh what is your callback number?
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] Thank you. And the member's policy number?
[CUSTOMER][NEUTRAL] It is 01909305 M as in Mary, L as in Larry 8.
[AGENT][NEUTRAL] OK, thank you, one moment.
[AGENT][NEUTRAL] OK, so first off, if you could please verify, uh, first off, any information that's provided would be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth?
[CUSTOMER][NEUTRAL] It is [PII] and his date of birth is [PII].
[AGENT][NEUTRAL] Thank you. And the date of service and total bill amount?
[CUSTOMER][NEUTRAL] It is [PII], and the total bill amount was $300.
[AGENT][NEUTRAL] OK, so the policy number you gave me is an old policy number, that policy number term back in
[AGENT][NEUTRAL] [PII], the policy that was active for your data service.
[AGENT][NEUTRAL] Is policy number 251.
[AGENT][NEUTRAL] 9699.
[AGENT][NEUTRAL] So give me just a moment, and that policy was active from [PII].
[AGENT][NEUTRAL] I'm gonna look on
[CUSTOMER][NEUTRAL] 8124 to 10 124.
[AGENT][NEUTRAL] Yes, ma'am. Uh-huh.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And there is no policy active at this time with our company.
[CUSTOMER][POSITIVE] Correct, OK.
[AGENT][NEUTRAL] Alright, so let me see, we processed.
[AGENT][NEUTRAL] That claim under the correct policy number.
[AGENT][NEUTRAL] OK, so we do not have a claim on file for him.
[AGENT][NEUTRAL] For data service 95 2024.
[CUSTOMER][NEUTRAL] OK. I had mailed it in, but maybe because it had the old policy number on it.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Well, when, if that's the case, we try, but I looked, it's not on either policy.
[CUSTOMER][NEUTRAL] OK, can I verify the mailing address?
[AGENT][NEUTRAL] So it's, yeah, go ahead. Mhm. What do you have?
[CUSTOMER][NEUTRAL] Um, I have, hold on, let me just get into that.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Pair.
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] That's a very old PO box. Correct. Yeah.
[CUSTOMER][NEUTRAL] That's not old. OK, so that's not even the right mailing address, OK.
[AGENT][NEUTRAL] No, it was at one point with that old policy, um, but no, ma'am, that's not the correct address now. It should be [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] That's in [PII].
[AGENT][NEUTRAL] And the zip code is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And when you do submit the claim, you may already be aware of this, but we will have to have a copy of the primary insurance company's, uh huh, explanation and benefits as well. And then once we process our claim, you should be able to check the claim status by going to our portal, [PII].
[CUSTOMER][NEUTRAL] Of the
[CUSTOMER][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, can I have a reference number for this call?
[AGENT][NEUTRAL] Sure, you're gonna use my name I gave you just with today's date.
[CUSTOMER][POSITIVE] OK, thank you very much.
[AGENT][POSITIVE] Well, you are certainly very welcome. Is there anything else that I can help you with today?
[CUSTOMER][POSITIVE] No, not at all, thank you.
[AGENT][POSITIVE] You're very welcome and thank you again for calling APL. I hope you have a great day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thank you. Bye-bye.