AccountId: 011433970860
ContactId: f303c030-59b9-4c2a-9a71-bfb578246d4e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 385880 ms
Total Talk Time (AGENT): 117971 ms
Total Talk Time (CUSTOMER): 156743 ms
Interruptions: 1
Overall Sentiment: AGENT=0.8, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/17/f303c030-59b9-4c2a-9a71-bfb578246d4e_20250117T15:30_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII], and I'm calling from provider's office to check on a claim status.
[AGENT][POSITIVE] OK, I'll be more than happy to assist you with the claim status, [PII], and how many claims do you have in total today?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] One.
[AGENT][NEUTRAL] OK, may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yes, that's [PII]. That's the direct line.
[AGENT][NEUTRAL] Thank you for that. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] Yes, D as in Delta 46401479.
[AGENT][POSITIVE] Thank you. Hold on one moment.
[AGENT][NEUTRAL] And do you have the member's ID card available?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] On the ID card, do you see anywhere that says in hospital or outpatient policy cert number?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Let me check that. Give me a moment.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] So.
[CUSTOMER][NEUTRAL] So.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] That's a group number.
[AGENT][NEUTRAL] OK, what's the group number?
[CUSTOMER][NEUTRAL] That's going to be 9464.
[AGENT][NEUTRAL] Do you have the member's social?
[CUSTOMER][NEUTRAL] Let me see.
[CUSTOMER][NEUTRAL] I do have the last 4 of social only.
[AGENT][NEUTRAL] OK, what's the member's first and last name?
[CUSTOMER][NEUTRAL] OK. First name is [PII] Last name [PII]
[AGENT][NEUTRAL] OK, I'll try to search with the name. Hold on one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And that was [PII]?
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] For the last name?
[CUSTOMER][NEUTRAL] Yes. [PII].
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] And this is for her medical policy?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, I believe I just located it. Hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And can you verify her date of birth?
[CUSTOMER][NEUTRAL] We
[CUSTOMER][NEUTRAL] Yes, [PII].
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] Alright, and thank you so much for verifying her information. So the policy number with APL is 255.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] 2578.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And we have not processed any claims for [PII] yet. Um, what's the date of service?
[CUSTOMER][NEUTRAL] That's [PII] bill amount $381.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. Um, so the policy has been active since [PII], but we have not processed any claims for the member. We don't, um, we don't have a claim on file.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK, can I please get the mailing address?
[AGENT][NEUTRAL] Sure, so it's [PII].
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] That
[AGENT][NEUTRAL] The zip code is [PII].
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK. Thank you. Actually, I do have a confusion here. Uh, you do not have the claim on file so I'm gonna resubmit the claim. But as for the insurance card, the ID, the member's ID is uh the one which I gave you. So, um, can you process the claim with that member ID because as per the insurance card, the correct member ID is that.
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] So that D number is for 90 degree benefits. You may see that on the card as well. That D number we cannot use in our system. You would have to use the policy number that's in our system, which is what we, I provided the 2552578.
[CUSTOMER][POSITIVE] Thank
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, great. OK, can I please have the call reference number and that's all.
[AGENT][NEUTRAL] Sure, so there's no call reference number, but you can use my name in today's date. Uh my first name is [PII], first initial to my last name is [PII], and then today's date.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][POSITIVE] OK then thank you so much [PII] for the information that's all for today and I hope you have a good day.
[AGENT][POSITIVE] Thank you also, darling. Thanks for calling APL. Bye-bye.
[CUSTOMER][NEUTRAL] Mhm bye bye.
[CUSTOMER][NEUTRAL] OK.