AccountId: 011433970860
ContactId: ee1faa8e-88de-4776-9636-c8c4c77ac525
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 511450 ms
Total Talk Time (AGENT): 91526 ms
Total Talk Time (CUSTOMER): 207594 ms
Interruptions: 1
Overall Sentiment: AGENT=0.8, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/04/ee1faa8e-88de-4776-9636-c8c4c77ac525_20250204T13:22_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] For calling APL, this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, good morning. My name is [PII] and I'm calling you from the provider office. I just want to know the claim status. Can you please help me?
[AGENT][NEUTRAL] OK. And you said your name is [PII]?
[CUSTOMER][NEUTRAL] No, my name is [PII] and the last two first my initial name is [PII].
[AGENT][NEUTRAL] [PII], and you check.
[AGENT][NEUTRAL] And you're checking claim status?
[CUSTOMER][POSITIVE] That is correct.
[AGENT][NEUTRAL] OK, what's the policy number?
[CUSTOMER][NEUTRAL] Let me check. I'm telling you the policy number for you.
[CUSTOMER][NEUTRAL] OK, the policy number is 02446503.
[AGENT][NEUTRAL] Your phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] Uh, the phone number is [PII].
[AGENT][NEUTRAL] And the patient
[AGENT][NEUTRAL] The patient's name and date of birth.
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] The patient name is [PII] and the patient date of birth, let me check.
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] Alright, and what's the date of service and the total charge?
[CUSTOMER][NEUTRAL] The date of service is [PII] with bill amount $3,715 even.
[AGENT][NEUTRAL] Give me the bill bill amount again please?
[CUSTOMER][NEUTRAL] Uh, $3,715 even.
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][POSITIVE] Take your time.
[AGENT][NEUTRAL] And this is a medical claim?
[CUSTOMER][NEUTRAL] Yeah, medical claim.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, I'm not showing date of service [PII] on file for [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, no problem, so we need to rebuild the claim, right?
[AGENT][NEUTRAL] I'm not showing it on file, so yes.
[CUSTOMER][NEUTRAL] OK, may I have your name? Can you spell out your name, please?
[AGENT][NEUTRAL] You'll use my name in today's date as your reference. [PII].
[AGENT][NEUTRAL] The first initial of my.
[CUSTOMER][NEUTRAL] [PII]. And what is your last initial?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The first initial of my last name is [PII].
[CUSTOMER][NEUTRAL] OK, so I need, I want to take the few information from your side. What is the PR ID number?
[AGENT][NEUTRAL] 60801.
[CUSTOMER][NEUTRAL] Uh, just one moment, 60801, got it. And what is the effective date of this number?
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] The policy term [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Got it. And what is the claim submission timely filing limit?
[AGENT][NEGATIVE] No timely filing limit.
[CUSTOMER][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] OK, so as you said, no claims, no com claim submission timely filing limit, right?
[CUSTOMER][NEUTRAL] OK, and what is the call reference number for this one?
[AGENT][NEUTRAL] My name and today's date and you can also check your status online at [PII] and I can help you set that account up if you would like.
[CUSTOMER][POSITIVE] OK. Thank you.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, OK, thank you so much for giving me the information. So I have last account for you. Just one moment, please stay on the call. First of all, I need to finish my note then I will, I will give you the next member ID number for you. Just one moment please.
[CUSTOMER][NEUTRAL] And apart from that, I, I want to, I have also the mailing address of this account, so I, I need to, yeah, I need to verify the mailing address where we need to rebuild the claim. So can you tell me the.
[AGENT][NEUTRAL] What address do you have?
[CUSTOMER][NEUTRAL] Yeah, I have [PII]. OK, [PII]. Is that right?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][POSITIVE] OK, thank you so much, [PII] for giving me the information. So please stay on the call. I'm giving you the next ID number for you just one moment.
[AGENT][NEUTRAL] Just a few moments I can hold.
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][POSITIVE] I can hold a few moments for you.
[CUSTOMER][NEUTRAL] Yeah, sure.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] And I'm gonna put you on a brief hold while you locate that information one moment.
[CUSTOMER][NEUTRAL] No, I, I, I have done from my end, so I'm ready to take the next member ID number. Uh, the next ID number is.
[CUSTOMER][NEUTRAL] 02446503.
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Can you hear me?
[CUSTOMER][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Are you still there?
[CUSTOMER][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Can you hear me?
[CUSTOMER][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Hello, can you hear me?
[CUSTOMER][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Hello, can you hear me?
[AGENT][NEUTRAL] Do you have the policy number?
[CUSTOMER][NEUTRAL] Hello, can you hear me? Yeah, I have the policy number, ma'am.
[AGENT][NEUTRAL] Do you have the policy number and that number?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, one moment, one moment.
[CUSTOMER][NEUTRAL] The next ID number is 02446503.
[AGENT][NEUTRAL] 02446503
[CUSTOMER][NEUTRAL] Actually I'm checking here uh it will be the same uh the date of service will be the different so I'm checking here it is under the same.
[CUSTOMER][NEUTRAL] Members. Only you need to check the
[AGENT][NEUTRAL] The date of service?
[CUSTOMER][NEUTRAL] Yeah, [PII] with the amount $1,644 even.
[AGENT][NEUTRAL] Procedure codes on the claim?
[CUSTOMER][NEUTRAL] Actually I'm not seeing anything over here.
[AGENT][NEUTRAL] OK, I don't show that claim on file at this time.
[CUSTOMER][NEUTRAL] OK, so as you said again no claim on file on the date of service, right?
[AGENT][NEUTRAL] I do not show that claim on file.
[CUSTOMER][NEUTRAL] OK, what I, OK, so I think the all information will be the same of the previous, right, because it is the same member, right?
[AGENT][POSITIVE] Correct.
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] OK. Right. Mhm. Thank you so much for giving me the information. Have a good day.
[AGENT][POSITIVE] Thank you for calling APL. Have a good day, [PII].
[CUSTOMER][POSITIVE] Thank you.