AccountId: 011433970860
ContactId: 0094b80a-10b7-471f-a800-9b43d95de9cf
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 712539 ms
Total Talk Time (AGENT): 182290 ms
Total Talk Time (CUSTOMER): 246074 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/23/0094b80a-10b7-471f-a800-9b43d95de9cf_20250123T13:27_UTC.wav
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[AGENT][NEUTRAL] Calling APL, this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Uh, yes, hi, this is [PII], and I need the claim information.
[AGENT][NEUTRAL] Your name is [PII]?
[CUSTOMER][NEUTRAL] Yes, yes.
[AGENT][NEUTRAL] And how can I help you?
[CUSTOMER][NEUTRAL] Uh, I need the claim information, checking on claim.
[AGENT][NEUTRAL] OK. And the policy number?
[CUSTOMER][NEUTRAL] OK. Policy number, one moment.
[CUSTOMER][NEUTRAL] One moment. 438-90001.
[AGENT][NEUTRAL] OK, that's not an APL policy number. Do you have a copy of the ID card?
[CUSTOMER][NEUTRAL] Uh, yes, it's a uh ID number 022 031110.
[AGENT][NEUTRAL] Say that one more time, a little slower, please.
[CUSTOMER][NEUTRAL] 022 031110.
[AGENT][NEUTRAL] OK and what's a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And you gave me policy number 0220131110?
[CUSTOMER][NEUTRAL] No, no, 022 03110.
[AGENT][NEUTRAL] 3110. OK. One moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And the patient's name and date of birth?
[CUSTOMER][NEUTRAL] OK. The name is [PII].
[AGENT][NEUTRAL] And the date of birth?
[CUSTOMER][NEUTRAL] Date of birth I have uh.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. And what is the date of service?
[CUSTOMER][POSITIVE] Sorry to have that.
[CUSTOMER][NEUTRAL] [PII] and uh.
[CUSTOMER][NEUTRAL] Amount is $11,883.10.
[AGENT][NEUTRAL] OK, 11,882 or 83?
[CUSTOMER][NEUTRAL] 837 8 3.10 is the amount and uh
[CUSTOMER][NEUTRAL] It service again 7723.
[AGENT][NEUTRAL] I'm sorry, can you repeat the total charge?
[CUSTOMER][NEUTRAL] $11,833.11 8. I'm sorry, 883.10. 11883.10.
[AGENT][NEUTRAL] 833.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And is this a facility charge?
[CUSTOMER][NEUTRAL] Mhm, yes.
[AGENT][NEUTRAL] OK, I'm not showing that date of service and charge on file for [PII].
[CUSTOMER][NEUTRAL] OK. So it means uh no claim on file, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK. May I have your name?
[AGENT][NEUTRAL] You'll use my name in today's date as reference for today's call, [PII].
[AGENT][NEUTRAL] ONYA first initial last name is [PII]. Any other questions, [PII] I could assist with today?
[CUSTOMER][NEUTRAL] Yes, yes, and the reference today she acted as a reference number, right?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] I'm saying today's date as the reference number, right?
[AGENT][NEUTRAL] My name and today's date as reference, yes, and you can check in.
[CUSTOMER][NEUTRAL] OK, and um uh
[CUSTOMER][NEUTRAL] Yes, um, uh, my apology. So can I get the effective date for this policy member is active on the service?
[AGENT][NEUTRAL] [PII] is the effective date.
[AGENT][NEUTRAL] The policy is no longer active as of [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Can I get that effect you one more time? July?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] 2
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, [PII] to current, right?
[AGENT][NEUTRAL] To [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And you can also check status on our online service center at [PII]. And did you have any other questions, [PII]?
[CUSTOMER][NEUTRAL] Yes, and what's the TFR to submit the claim?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] I'm saying what is the time refunding limit to submit the claim?
[AGENT][NEUTRAL] There's no timely filing limit to submit a claim?
[AGENT][NEUTRAL] And are you calling for the actual provider's office?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, yes.
[AGENT][NEUTRAL] What's the name of the facility?
[CUSTOMER][NEUTRAL] OK, sure, facility in Southside original Medical Center.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Southside Medical Center.
[AGENT][NEUTRAL] OK. Anything else?
[CUSTOMER][NEUTRAL] Yes, I have another. OK, so, uh, the name is Bondakers Hospital.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And I have another claim, so just a moment, let me pull up the account.
[AGENT][NEUTRAL] Is it for this patient or a different person?
[CUSTOMER][NEUTRAL] Uh, one moment.
[CUSTOMER][NEUTRAL] Different person.
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][POSITIVE] Take your time.
[CUSTOMER][NEUTRAL] Please let me know once you're ready.
[AGENT][NEUTRAL] And the last policy number?
[CUSTOMER][NEUTRAL] Mhm. Sure.
[CUSTOMER][NEUTRAL] OK. Next policy, policy number I have a.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] 01477436
[AGENT][NEUTRAL] The patient's name and date of birth?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Patient name is [PII]
[CUSTOMER][NEUTRAL] And the date of birth is uh [PII].
[AGENT][NEUTRAL] OK, and the date of service and build them out?
[CUSTOMER][NEGATIVE] Get of service I have uh
[CUSTOMER][NEUTRAL] 817 or 23 amount 2971, even.
[AGENT][NEUTRAL] OK, you said [PII]?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] OK and uh what are the procedure codes on the claim?
[CUSTOMER][NEUTRAL] I'm sorry?
[AGENT][NEUTRAL] Is this a facility charge or professional fee?
[CUSTOMER][NEUTRAL] Uh, facility charge.
[AGENT][NEUTRAL] OK, I'm not showing a facility charge on file for this patient. Um, I do show that this policy is effective [PII]. The policy is currently active.
[CUSTOMER][NEUTRAL] I'm sorry, please with the bacteria [PII] to current, right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, no fine. Thank you.
[CUSTOMER][NEUTRAL] Uh just.
[AGENT][NEUTRAL] Any other questions?
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Yes, I have another cream.
[CUSTOMER][NEUTRAL] I have another claim.
[AGENT][NEUTRAL] OK, OK, I can do one more claim, [PII]. What's the policy number?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, policy number.
[CUSTOMER][NEUTRAL] Just a second.
[CUSTOMER][NEUTRAL] OK, next I have uh
[CUSTOMER][NEUTRAL] 98 4 times 0. No, no, no, one moment. That's uh 022.
[CUSTOMER][NEUTRAL] OK. 02292711.
[CUSTOMER][NEUTRAL] 02292711. And uh
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Sure, sure.
[AGENT][NEUTRAL] And the next policy number?
[AGENT][NEUTRAL] It's 229-2711. What's the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII], and the last name [PII] Date of birth.
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] OK, and what's the date of service?
[CUSTOMER][NEUTRAL] Date of service, sir.
[CUSTOMER][NEUTRAL] [PII] or [PII] to [PII] or [PII] [PII], I'm sorry, uh 429 4279.97. So please check we have claim for this one.
[AGENT][NEUTRAL] So the date of service is [PII] through.
[CUSTOMER][NEUTRAL] And in
[AGENT][NEUTRAL] [PII], the total charge is 42,000.
[AGENT][NEUTRAL] $794.97.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] No, no, $4,279.97.
[AGENT][NEUTRAL] 0, 4000. OK.
[AGENT][NEUTRAL] 4279.97. OK.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And I do not show this claim on file for the patient.
[CUSTOMER][NEUTRAL] OK, and that is uh.
[CUSTOMER][NEUTRAL] And that we submitted this claim on this address [PII]. It this is the correct address, right?
[AGENT][NEUTRAL] Uh, that's not the correct address. The correct mailing address is [PII]. You [PII] [PII]?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] The state and the zip code?
[CUSTOMER][NEUTRAL] Uh, zip code uh.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Yeah, that is the correct address.
[CUSTOMER][MIXED] OK, but you have to resubmit and the member active of from uh.
[CUSTOMER][NEUTRAL] Uh, [PII], right?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][POSITIVE] It's like, OK, so thank you so much, uh, have a nice day bye.
[AGENT][POSITIVE] You're welcome. Thanks for calling APL. Have a good day, [PII].
[CUSTOMER][NEUTRAL] Bye.