AccountId: 011433970860
ContactId: f7212fa6-8945-498a-8b04-beb6964da009
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 451709 ms
Total Talk Time (AGENT): 138832 ms
Total Talk Time (CUSTOMER): 113366 ms
Interruptions: 3
Overall Sentiment: AGENT=0.1, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/19/f7212fa6-8945-498a-8b04-beb6964da009_20250219T14:57_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Uh, I need claim status.
[AGENT][NEUTRAL] OK, uh, sure, I can assist you with claim status. May I have your name?
[CUSTOMER][NEUTRAL] My first name is [PII] and the last initial to my name is [PII].
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] And may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and may I have the name of where you're calling from?
[CUSTOMER][NEUTRAL] I'm calling from urgent care physician of West Kendal LLC.
[AGENT][NEUTRAL] OK, and
[AGENT][NEUTRAL] May I have the patient's policy number?
[CUSTOMER][NEUTRAL] Yeah, give me a second. Let me look up at the patient policy. The patient policy number is
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 23,090.
[AGENT][NEUTRAL] Do you have any other numbers besides that the small number?
[CUSTOMER][NEUTRAL] No, I don't have any other number.
[AGENT][NEUTRAL] Mm, OK, that may be a group number. Let me see if I can find it under the group.
[CUSTOMER][NEUTRAL] May I tell you the member first name, last name, and date of birth or SSN number?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, one moment, let me pull another system, one moment.
[CUSTOMER][NEUTRAL] Yeah, uh
[AGENT][NEUTRAL] OK, go ahead with the SSN number.
[CUSTOMER][NEUTRAL] SSN number is [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][POSITIVE] Yes, it's correct.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] The social is not pulling anything up. Um, do you know if he's a depending or he's the main holder of the of the policy, Mr. [PII]?
[CUSTOMER][NEUTRAL] I think it's a spouse.
[CUSTOMER][NEUTRAL] Is the, the policy is uh spouse, I think, yeah, that is correct.
[AGENT][NEUTRAL] Oh OK.
[AGENT][NEUTRAL] Yeah, we cannot pull with the, with the dependent, uh-huh. It has to be with the social of the primary holder. Um, do you have a social by any chance?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No, I don't have the social for the primary member.
[AGENT][NEUTRAL] No. OK. What's the spelling of the last name and the first name of the member, I need the last name first.
[CUSTOMER][NEUTRAL] Last name uh of the member, the member uh who is the policyholders.
[AGENT][NEUTRAL] Of, of the, no, of the, the, the patient, I'm sorry, yes, mhm.
[CUSTOMER][NEUTRAL] Patient.
[CUSTOMER][NEUTRAL] OK. [PII].
[AGENT][NEUTRAL] OK, and the spelling of the first name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, maybe this one, bear with me just a second, let me see if I can find her.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] What's her date of birth?
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] And you said you're calling for claim status correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, what is the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] Date of service is [PII].
[AGENT][NEUTRAL] OK, how much is the total charge?
[CUSTOMER][NEGATIVE] $211 even. It's $211 even.
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] OK, I don't have that claim on file. Um, now, the policy that I found is an old policy. She doesn't have any active policy for that date of service. Um, the one that I did find was terminated [PII].
[CUSTOMER][NEUTRAL] OK, give me a second, uh.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Well
[CUSTOMER][NEUTRAL] OK, ma'am, give me a second, wait for a second.
[AGENT][NEUTRAL] Mm, true.
[CUSTOMER][NEUTRAL] Yeah, ma'am, uh, the member is not active on the date of service.
[AGENT][NEUTRAL] Correct, yes. The only policy that I found uh was effective [PII] and it terminated [PII].
[CUSTOMER][NEUTRAL] OK. Uh, so,
[CUSTOMER][NEUTRAL] No, no, that, ma'am, may I know the call reference for this case? No go to.
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in today's date.
[CUSTOMER][NEUTRAL] Ma'am, may you spell your name?
[AGENT][NEUTRAL] That's [PII].
[CUSTOMER][NEUTRAL] OK.