AccountId: 011433970860
ContactId: fca8ea98-5437-476d-ac06-29acb5fbf811
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 511459 ms
Total Talk Time (AGENT): 134489 ms
Total Talk Time (CUSTOMER): 167992 ms
Interruptions: 5
Overall Sentiment: AGENT=1.5, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/07/fca8ea98-5437-476d-ac06-29acb5fbf811_20250507T15:25_UTC.wav
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[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from Pros office to checking the claim status.
[AGENT][POSITIVE] Thank you for calling CPL.
[AGENT][NEUTRAL] How may I help you?
[CUSTOMER][NEUTRAL] Hello? Can you hear me?
[AGENT][NEUTRAL] OK, I can help you with claim status, [PII], yes sir, I can hear you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Can you please give me your callback number, sir, just in case the call is disconnected.
[CUSTOMER][NEUTRAL] Yeah, go ahead. Uh, may I know your name sir?
[AGENT][NEUTRAL] Yes, my name is [PII]
[AGENT][NEUTRAL] And what is your callback number, [PII]?
[CUSTOMER][NEUTRAL] I'm
[CUSTOMER][NEUTRAL] And that is [PII]. It is a direct line. And your name is [PII], right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, got it.
[AGENT][NEUTRAL] And what is the um the patient's name, date of birth and policy number so I can get claim status for you?
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] Sure. My name is [PII].
[CUSTOMER][NEUTRAL] And the number's date of birth is [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Hello? Can you hear me?
[AGENT][NEUTRAL] Yes I can hear you and what is the policy number?
[CUSTOMER][NEUTRAL] Yeah, the policy number is 1246595 M as in Mike L as in Lima 7.
[AGENT][NEUTRAL] OK, let me look that up real quick.
[AGENT][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, I'm not finding a member on this policy by the name of [PII] with the date of birth of [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] No member on file.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] OK. OK.
[CUSTOMER][NEUTRAL] Uh, uh, I will repeat them right again. Could you please verify, or shall I provide the SSN number for this member? Could you please verify on that with that?
[AGENT][NEUTRAL] Let me, yes, what is the social?
[CUSTOMER][NEUTRAL] Yeah, that is
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, let me put my note in and then I will look up by the social. It'll be just a second.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] And what's the name of the provider's office you're calling from, Leo?
[CUSTOMER][NEUTRAL] Uh, from JMG Specialty physician.
[CUSTOMER][NEUTRAL] What is Jackson Medical Group.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, let me, I think one man.
[AGENT][NEUTRAL] OK, I think I have one pulled up. Let me check real quick and make sure the policy is active for [PII]. OK, and then what is one's data service?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] And the charge amount please?
[CUSTOMER][NEUTRAL] Um, $70 even.
[AGENT][NEUTRAL] OK, and what are the charges after the primary insurance paid their part?
[CUSTOMER][NEUTRAL] Oh yeah, that is $191 even.
[AGENT][NEUTRAL] And that's after the primary?
[CUSTOMER][NEUTRAL] Oh, after the primary, the $70 even.
[AGENT][POSITIVE] OK, alright, thank you so much, [PII]. I'm gonna put you on a quick hold while I look up this claim for us and I'll be right back sir.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK [PII], on the service of [PII]. I do not find a claim on file, but let me give you the good policy number so that you can resubmit it.
[AGENT][NEUTRAL] Are you ready?
[AGENT][NEUTRAL] Are you there?
[CUSTOMER][POSITIVE] Yeah, I'm ready. I'm ready.
[AGENT][NEUTRAL] Can you
[AGENT][NEUTRAL] OK, OK, I couldn't hear you. OK, so the good policy number is 255.
[CUSTOMER][NEGATIVE] Oh sorry.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 644-7.
[CUSTOMER][NEUTRAL] 644-7, right?
[AGENT][NEUTRAL] 2556447
[CUSTOMER][NEUTRAL] But and what is the time deciding to submit the claim?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] We do not have one.
[CUSTOMER][NEUTRAL] Got it.
[CUSTOMER][POSITIVE] Alright, thank you so much. May I get the call reference number?
[CUSTOMER][NEUTRAL] And that's what
[AGENT][NEUTRAL] Yes sir, you can use my name [PII] in today's date.
[CUSTOMER][NEUTRAL] Uh, that's uh [PII], right?
[AGENT][POSITIVE] [PII], yes sir.
[CUSTOMER][POSITIVE] Got it thank you so much. Yeah, thank you for the information. Bye bye take care.
[AGENT][POSITIVE] You're very welcome. Is that everything I can help you with today?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] No, everything is perfect.
[AGENT][POSITIVE] OK, thank you [PII] you have a wonderful day thank you for calling APL.
[CUSTOMER][NEUTRAL] Yeah, well
[AGENT][NEUTRAL] Bye bye sir.