AccountId: 011433970860
ContactId: f6dadfde-fa24-41b3-89e8-c9bf1bcfee15
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 393320 ms
Total Talk Time (AGENT): 144443 ms
Total Talk Time (CUSTOMER): 191520 ms
Interruptions: 8
Overall Sentiment: AGENT=0.8, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/29/f6dadfde-fa24-41b3-89e8-c9bf1bcfee15_20250129T13:34_UTC.wav
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[AGENT][POSITIVE] Good morning thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII]. My name is [PII] calling for the Commonwealth Pain Associates. We're gonna claim status. Please be informed that this call is being recorded and monitor for quality and training purposes. Hi [PII], how are you?
[AGENT][POSITIVE] Hi, and I'm good and how are you today?
[CUSTOMER][POSITIVE] Yeah, I'm good. Thank you for asking. And how do you spell your name?
[AGENT][NEUTRAL] Good. And you said you're [PII] and
[CUSTOMER][POSITIVE] I'm so sorry.
[AGENT][NEUTRAL] [PII] And you said that your name is [PII], like the month?
[CUSTOMER][NEUTRAL] Uh OK. Mhm.
[CUSTOMER][NEUTRAL] No, no, no, no. No, no, no. My name is [PII]
[AGENT][NEUTRAL] OK, [PII]. Thank you. And your callback number?
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Yeah, sure.
[CUSTOMER][NEUTRAL] The callback number is [PII] and it is a direct line.
[AGENT][NEUTRAL] OK, thank you and how many claims do you have to check status on today?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] I have only one claim for the day.
[AGENT][NEUTRAL] OK. Um, and what is that member's policy number?
[CUSTOMER][NEUTRAL] Yeah, sure. The policy number is 02342158.
[CUSTOMER][NEUTRAL] That
[AGENT][POSITIVE] OK, thank you. Give me a couple of moments to get the member's information pulled up please.
[CUSTOMER][NEUTRAL] Yeah, sure.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, and any information that I do provide for you today, [PII] will be a verification of benefits and not a guarantee of payment. Also, if we do have the claim on file and you need a copy of the explanation of benefits, you may obtain that by going to our portal at [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] And what is your patience?
[CUSTOMER][NEUTRAL] It is, sorry? Yeah.
[AGENT][NEUTRAL] Uh [PII].
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] So.
[AGENT][NEUTRAL] And what is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] Yeah, sure.
[CUSTOMER][NEUTRAL] The patient name is uh [PII] and date of birth is [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] It
[AGENT][NEUTRAL] And what is the date of service and total bill amount for him please [PII]?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, sure. The rate of service is [PII] and uh total bill amount is $250 even.
[AGENT][NEUTRAL] 250.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK [PII], there is no claim on file for this member for this data service.
[CUSTOMER][NEUTRAL] OK. So for the date of service, you don't know.
[AGENT][NEGATIVE] This policy was not active.
[AGENT][NEUTRAL] That is correct, this policy was not active for that data service.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. The patient is not acting on the date of service, am I right?
[AGENT][POSITIVE] That is correct. The policy had an effective.
[CUSTOMER][NEUTRAL] OK. Yeah, go ahead.
[AGENT][NEUTRAL] Date of [PII].
[AGENT][NEUTRAL] Excuse me, [PII].
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] And the term date on it was [PII].
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Um.
[AGENT][NEUTRAL] And there is no other coverage.
[CUSTOMER][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] With our company.
[CUSTOMER][POSITIVE] I'm so sorry. What did you say?
[AGENT][NEUTRAL] No other policy.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, so you say the patient is, uh, I mean the policy effective date is [PII], right?
[CUSTOMER][NEUTRAL] No
[AGENT][NEUTRAL] No, I didn't say that.
[CUSTOMER][NEUTRAL] OK. Could you please repeat it?
[AGENT][NEUTRAL] I said the policy is effective [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And it turned [PII].
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK. And the patient has no other active insurance, right?
[AGENT][NEUTRAL] Uh, not with our company.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] And does the policy got renewed after the termination.
[AGENT][NEUTRAL] Pardon me?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Uh-huh. Policy does not renewed after the termination, right?
[AGENT][NEUTRAL] That is correct. There is no other policy with our company.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] At this time.
[CUSTOMER][NEUTRAL] OK, so as of now, the patient is not active on date of service and patient has no other active insurance. That's not renew the policy after termination. OK, no problem, [PII]. May I know the call reference number for this claim?
[AGENT][NEUTRAL] My name and today's date.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] I'm
[CUSTOMER][NEUTRAL] Your name, right?
[AGENT][NEUTRAL] My name and today's date.
[CUSTOMER][NEUTRAL] So,
[CUSTOMER][POSITIVE] OK, [PII]. Thank you so much. Thank you for your assistance. I hope you enjoy your day. Be safe. Take care. Bye-bye.
[AGENT][NEUTRAL] You're welcome, [PII].
[AGENT][POSITIVE] Hi, have a nice day and thank you again for calling APL.
[CUSTOMER][NEUTRAL] Bye-bye.
[AGENT][NEUTRAL] Um, bye-bye.
[AGENT][NEUTRAL] OK