AccountId: 011433970860
ContactId: f0b0b5d0-2d2b-416a-b018-a34f49848f21
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 263429 ms
Total Talk Time (AGENT): 91613 ms
Total Talk Time (CUSTOMER): 117478 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/21/f0b0b5d0-2d2b-416a-b018-a34f49848f21_20250121T15:52_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from provide office. I'm looking for a claims and your name. Could you please spell your name?
[AGENT][NEUTRAL] My name is [PII]. Can I have your name again and the call back number for you and that policy number?
[CUSTOMER][NEUTRAL] Sure. [PII] is [PII]
[CUSTOMER][NEUTRAL] And my callback number is [PII]. It's a direct line.
[AGENT][NEUTRAL] Thank you and the policy number of the member?
[CUSTOMER][NEUTRAL] And the and the
[CUSTOMER][NEUTRAL] Yeah, the policy number is 02388269.
[CUSTOMER][NEUTRAL] Yeah, that's the one you are part of it.
[AGENT][NEUTRAL] Could you verify the patient's name and date of birth that you're inquiring claim status for?
[CUSTOMER][NEUTRAL] What
[CUSTOMER][NEUTRAL] Sure, it's [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] Are you calling about dental or medical?
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] Medical.
[CUSTOMER][NEUTRAL] You know, we help them to claim with you on a phone.
[CUSTOMER][NEUTRAL] Alright
[AGENT][NEUTRAL] And what is the date of service that you're inquiring to claim status for?
[CUSTOMER][NEUTRAL] The data service is [PII] and the total charge number is $4540.05.
[CUSTOMER][NEUTRAL] Maybe.
[AGENT][NEUTRAL] OK, Jo, [PII] you said [PII]?
[AGENT][NEUTRAL] Of [PII].
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] I'm not showing a claim on file for [PII] listed under this member's policy.
[CUSTOMER][NEUTRAL] OK. And we made a call also on the main month of last year. They said the claim was not on file and the patient was effective from [PII] to [PII]. They advise us to send the claim to fax.
[CUSTOMER][NEUTRAL] As per calling, we have submitted the claim. Yes, as per calling, we have sent the claim through the fax. Could you please check with that on May and we have submitted the claim.
[AGENT][POSITIVE] That is correct.
[AGENT][NEUTRAL] Could you verify the fax number that you sent it over to?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII]. What you said [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] That is correct, however, there is no claim on file.
[CUSTOMER][NEUTRAL] If the patient effect was right which as I said.
[AGENT][POSITIVE] Yes, that is correct.
[CUSTOMER][NEUTRAL] OK. What is the mailing address to submit the claim?
[AGENT][NEUTRAL] Give me one moment.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I have to claim them but could you please read for that.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] So the mailing address to submit a claim.
[AGENT][NEUTRAL] Will be [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII] is [PII].
[CUSTOMER][NEUTRAL] Uh, what is the time you failing to submit the claim?
[AGENT][NEUTRAL] There's no timely filing. Would you like to payer ID as well?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] 64556. That's 64556.
[CUSTOMER][NEUTRAL] OK, and the patient affected it is right, is that right?
[AGENT][NEUTRAL] Yes, that is correct. The patient's effective date is [PII]. And there's no active policy here at American Public Life.
[CUSTOMER][NEUTRAL] OK fine.
[AGENT][NEUTRAL] Is there anything else that I can assist you with today?
[CUSTOMER][NEUTRAL] No, that's fine. And uh could you please provide me the call reference?
[AGENT][NEUTRAL] We don't provide reference numbers job, but you can use my name in today's date as a reference.
[CUSTOMER][NEUTRAL] OK, and the attention to submit the claim.
[AGENT][NEUTRAL] Attention claims department.
[CUSTOMER][NEUTRAL] of [PII].
[CUSTOMER][POSITIVE] Thank you so much.
[AGENT][POSITIVE] You're welcome. Thanks for calling APL. Have a good day. Bye bye.
[CUSTOMER][NEUTRAL] Bye.