AccountId: 011433970860
ContactId: f21d657a-52a8-4674-bdf9-249d14d9430a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 460920 ms
Total Talk Time (AGENT): 130332 ms
Total Talk Time (CUSTOMER): 139508 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/03/f21d657a-52a8-4674-bdf9-249d14d9430a_20250103T21:14_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII]. I'm calling from provider's office. And I'm looking for members, oh sorry, it's claim status. Could you help me with that?
[AGENT][NEUTRAL] Yes, I can help you with claim status [PII], what is your callback number just in case the call is dropped.
[CUSTOMER][NEUTRAL] Yes, my callback number is [PII] with an [PII].
[AGENT][NEUTRAL] Thank you, sir. And then what's the patient's name?
[CUSTOMER][NEUTRAL] Yes, patient name is [PII].
[CUSTOMER][NEUTRAL] We can reach
[AGENT][NEUTRAL] And what's [PII]'s date of birth?
[CUSTOMER][NEUTRAL] Yes, it is [PII].
[AGENT][NEUTRAL] And her policy number?
[CUSTOMER][NEUTRAL] It is 021-73645 M as in Mike, L as in Lima, number 8.
[AGENT][NEUTRAL] Thank you. And then what is the date of service, please?
[CUSTOMER][NEUTRAL] Yes, it is [PII].
[AGENT][NEUTRAL] And the charge amount please?
[CUSTOMER][NEUTRAL] Yes, it is $450 even.
[AGENT][NEUTRAL] OK, and then what's the charges after primary paid their part?
[CUSTOMER][NEUTRAL] Uh, just a moment, just one moment. I can find this information.
[AGENT][POSITIVE] Thank you, sir.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 8.
[CUSTOMER][NEUTRAL] Then how to improve.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Just one moment, please stay on the line.
[AGENT][POSITIVE] Yes. Yes, that's fine. Take your time.
[CUSTOMER][POSITIVE] OK, thank you so much for patiently waiting and.
[CUSTOMER][NEGATIVE] Unfortunately, I don't have the primary payment information in my end.
[AGENT][NEUTRAL] OK, that, that's fine. I'll still look it up. um, can you still give me the um name of the facility you're calling for?
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] Yes, the facility name is Metri Medical Care.
[AGENT][NEUTRAL] OK, I'm gonna put you on a brief hold, [PII] while I look up this claim for you and I'll be right back sir.
[CUSTOMER][POSITIVE] Yeah, sure. Take your time.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] I just wanted to double check with you that the data service was [PII].
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] Yes, that is right.
[AGENT][NEUTRAL] OK, I am not finding a claim on file for [PII].
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] OK. Thank you so much for this information. So, uh, if it is possible for we, uh, try to again submit this claim?
[AGENT][POSITIVE] Yes, you can resubmit it.
[CUSTOMER][NEUTRAL] OK. And for the submission, may I know the claim mailing address?
[AGENT][NEUTRAL] Yes sir, it is [PII].
[AGENT][NEUTRAL] And that's in [PII].
[AGENT][NEUTRAL] And the zip code is [PII].
[CUSTOMER][NEUTRAL] And there is any electronic mail ID?
[AGENT][NEUTRAL] Yes, sir. It's [PII].
[CUSTOMER][NEUTRAL] And may I know the family funding limit for the claim submission?
[AGENT][NEUTRAL] There isn't one.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][POSITIVE] OK, so thank you so much and
[CUSTOMER][NEUTRAL] Uh, may I know this member's plan effective date?
[AGENT][NEUTRAL] Yes, it is.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] you currently still at your home, right?
[AGENT][NEUTRAL] No, the policy lapsed on [PII].
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][POSITIVE] OK. OK, thank you so much for this information and
[CUSTOMER][NEUTRAL] Uh, may I know the plan name for this member?
[AGENT][NEUTRAL] Yes, it's um [PII]
[AGENT][NEUTRAL] Um, looking after I noticed that the policy lapsed looking, I do see that they have an active policy. Oh well, the effective date is [PII], so that still won't help.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Oh, OK. OK, thank you so much for this information. And this will have any group number for your billing purpose?
[AGENT][NEUTRAL] Yes, let me give you the group number.
[AGENT][NEUTRAL] Group number is 21564.
[AGENT][NEUTRAL] And that is
[AGENT][NEUTRAL] Care Elementary School.
[CUSTOMER][POSITIVE] OK. Thank you so much for this information. And may I know the car reference number for this call?
[CUSTOMER][NEUTRAL] me
[AGENT][NEUTRAL] Yes sir, um, you can use my name, [PII], and today's date.
[CUSTOMER][NEUTRAL] And your name is spelled as [PII]?
[AGENT][POSITIVE] [PII], yes sir.
[CUSTOMER][POSITIVE] Oh, OK. Thank you so much and thank you for assisting me. You have a great day and happy weekend. Bye-bye.
[AGENT][POSITIVE] You're very welcome.
[AGENT][POSITIVE] You too, [PII] thank you you have a great day also thanks for calling APL bye bye.
[CUSTOMER][NEUTRAL] Right