AccountId: 011433970860
ContactId: ef0f1e23-e9e5-47d2-b99d-905a93bf3eb1
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 421839 ms
Total Talk Time (AGENT): 128174 ms
Total Talk Time (CUSTOMER): 111435 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/12/ef0f1e23-e9e5-47d2-b99d-905a93bf3eb1_20250512T18:41_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]. My name is [PII] calling from providers office to check on a client status.
[AGENT][POSITIVE] OK, well, I'll be more than happy to help you with the claim status, [PII], and may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes, it is [PII].
[AGENT][NEUTRAL] Thank you for that. And the member's policy number?
[CUSTOMER][NEUTRAL] 02128207.
[AGENT][NEUTRAL] Thank you. And how many claims do you have in total today?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] 1
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Yes, ma'am. My name [PII]. Date of birth, [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And may I have the date of service and the total bill for the claim you like me to check on?
[CUSTOMER][NEUTRAL] Yes, it is [PII], and the bill amount is $256 even.
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] I don't know
[AGENT][NEUTRAL] OK, so this policy is no longer active as of [PII]. The active policy during this time of policy number 2173604.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Uh, could you please repeat that one more time, [PII]?
[AGENT][NEUTRAL] 217.
[AGENT][NEUTRAL] 3604.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] This policy has been active um since [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So I'm gonna check this policy to see if there's a claim here. Hold on one moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I mean.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] And I was like
[AGENT][NEUTRAL] And you said the total bill is 256?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And do you mind if I place you on just a brief hold while I look through these claims?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] Alright, hold on one moment.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEGATIVE] Yeah. You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Hello, [PII].
[CUSTOMER][NEUTRAL] Yes, I know.
[AGENT][NEUTRAL] All right, thank you so much for holding. I apologize for that wait. Um, so I'm showing that the claim was received on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The claim number is 353.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] 2927.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And on [PII], the claim was denied.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, as the policy does not provide a benefit in which no charges were incurred.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So the number member ID you gave me 2173604 it was active during the date of service.
[AGENT][NEUTRAL] Yes, this policy has been active since [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Can I get the mailing address, claims mailing address?
[AGENT][NEUTRAL] Yes, it's [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The zip code is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Thank you. And uh can I get the timely selling limit?
[AGENT][NEUTRAL] So there's no timely filing as long as the policy is active on the data service, you can file at any time.
[CUSTOMER][NEUTRAL] You
[CUSTOMER][POSITIVE] Mhm. OK, thank you.
[AGENT][POSITIVE] You're welcome. Was there anything else I can assist you with today?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Nothing. Can I get the call reference number?
[AGENT][NEUTRAL] So there's no call reference number, but you can use my name in today's date. So again, that's [PII] and today's date.
[CUSTOMER][POSITIVE] OK, [PII], thank you. Thank you for your assistance.
[AGENT][POSITIVE] You're very welcome and thanks for calling APS. I hope you have a great week.
[CUSTOMER][POSITIVE] You too. Good day. Bye-bye, [PII].
[AGENT][POSITIVE] Thank you bye bye.
[CUSTOMER][NEUTRAL] Mhm.