AccountId: 011433970860
ContactId: edd51e43-7470-4540-9d80-f9defad8b346
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 782039 ms
Total Talk Time (AGENT): 128386 ms
Total Talk Time (CUSTOMER): 224588 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/25/edd51e43-7470-4540-9d80-f9defad8b346_20250325T18:26_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, sir. Uh, my name is [PII] calling from provider's office to check on the claim status.
[AGENT][POSITIVE] I'm happy to check on a claim for you today, [PII]. Can I get the patient's policy number?
[CUSTOMER][NEUTRAL] Oh yeah, sure. Uh, but before I proceed, please be informed that this call is being recorded for quality and training purposes. Would you like us to continue recording?
[AGENT][NEUTRAL] Yes, that's fine.
[CUSTOMER][POSITIVE] Yeah, thank you so much. And the member ID is, it's uh M as in Mike, E as in Echo.
[CUSTOMER][NEUTRAL] 096
[CUSTOMER][NEUTRAL] 7709.
[AGENT][NEUTRAL] All right, one moment, [PII]. And do you have a good callback number?
[CUSTOMER][NEUTRAL] Yeah, sure, it's [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And if I can get the patient's name and date of birth?
[CUSTOMER][NEUTRAL] The patient's name is [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] The member's policy number didn't pull up their information. Do you have their social?
[CUSTOMER][NEUTRAL] Oh, actually, no. Can you please check with the member, uh, first name, last name, and date of birth?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm spell the last name for me, please.
[CUSTOMER][NEUTRAL] Yeah, it's uh the last name is [PII]. It's uh [PII].
[AGENT][POSITIVE] Thank you. First name?
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And what was [PII]'s date of birth again, please?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Alright. Thank you. And then what's the date of service?
[CUSTOMER][NEUTRAL] Uh, the date of service it's uh [PII].
[AGENT][NEUTRAL] OK, no claims on file for [PII]. I'm not showing that the member had an active plan with us at the time of service.
[CUSTOMER][NEUTRAL] OK, uh, the patient policy effective on termination dates, can you please tell me that?
[AGENT][NEUTRAL] The effective date is [PII].
[AGENT][NEUTRAL] Showing that patient's plan terminated on [PII].
[CUSTOMER][NEUTRAL] OK. Is there any other insurance uh on your file?
[AGENT][NEUTRAL] Not that I'm seeing.
[CUSTOMER][NEUTRAL] OK, no other insurance is there, OK.
[CUSTOMER][NEUTRAL] And uh can you please uh tell me uh the member ID uh what you have in your end for this patient?
[AGENT][NEUTRAL] Uh, the patient policy number we have is 920.
[AGENT][NEUTRAL] 059.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, mm.
[CUSTOMER][NEUTRAL] OK. Uh, can you please, uh, spell out your name?
[AGENT][NEUTRAL] My name is spelled [PII].
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK, initial and last name?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] OK, thank you so much for that and uh can you please uh tell me the uh call reference number for this one and actually I'm having more 3 claims with me. Could you please help me on that?
[AGENT][NEUTRAL] Yes, call reference is my name with my last initials in today's date.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, can we move to the next one?
[AGENT][NEUTRAL] Uh, one moment, let me just finish noting this.
[CUSTOMER][POSITIVE] Yeah, take your time.
[CUSTOMER][NEUTRAL] Like
[AGENT][NEUTRAL] What's the next member ID?
[CUSTOMER][NEUTRAL] It's uh
[CUSTOMER][NEUTRAL] H as in Hotel. H as in Hotel. W as in Whiskey. B as in Bravo, 81694.
[AGENT][NEUTRAL] That's not one of our policy numbers. Do you have their social or I can search by name?
[CUSTOMER][NEUTRAL] Uh, can you please search with name?
[AGENT][NEUTRAL] Last name?
[CUSTOMER][NEUTRAL] The last name is [PII].
[AGENT][NEUTRAL] First name?
[CUSTOMER][NEUTRAL] It's [PII]. It's [PII].
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] Um, spell the patient's first name again one more time, please. [PII].
[CUSTOMER][NEUTRAL] It's [PII]. It's uh [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] you
[AGENT][NEUTRAL] What state does the patient live in?
[CUSTOMER][NEUTRAL] Uh, [PII].
[CUSTOMER][NEUTRAL] Um.
[AGENT][NEUTRAL] You don't have a claim number or anything like that, correct?
[CUSTOMER][NEUTRAL] No, I don't have any claim number.
[CUSTOMER][NEUTRAL] He
[CUSTOMER][NEUTRAL] Did
[AGENT][NEUTRAL] Is she the subscriber, do you know, or is she a dependent?
[CUSTOMER][NEUTRAL] Uh, she is a subscriber.
[AGENT][NEUTRAL] OK, I'm not able to find a member plan with that information.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Would you like to move on to the next one?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] What's the next policy number?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Uh, the next member ID is, it's uh.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Uh, it's M as in Mike.
[CUSTOMER][NEUTRAL] 00
[CUSTOMER][NEUTRAL] 00
[CUSTOMER][NEUTRAL] 3758.
[AGENT][NEUTRAL] We'll have to search by name. That's not one of our policy numbers. What's the member's last name?
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] He's an equal.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] First name?
[CUSTOMER][NEUTRAL] It's [PII], it's [PII].
[CUSTOMER][NEUTRAL] I didn't you in.
[AGENT][NEUTRAL] That
[AGENT][NEUTRAL] There's no policy that comes up under that name under [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Can we move to the next one?
[AGENT][NEUTRAL] Mhm. Go ahead when you're ready.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] And the next member ID is, it's uh [PII] as in Hotel, H as in Hotel, W as in Whiskey.
[CUSTOMER][NEUTRAL] Mm, right, no, no, that's it for the day and, uh, yeah, that's it for the day, [PII], sorry for that.
[AGENT][POSITIVE] All right. Have a good day, [PII].
[CUSTOMER][POSITIVE] Yeah, thank you so