AccountId: 011433970860
ContactId: 018ca0ea-34ca-4e12-8f2f-7811f23faf92
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 449500 ms
Total Talk Time (AGENT): 143789 ms
Total Talk Time (CUSTOMER): 99715 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/13/018ca0ea-34ca-4e12-8f2f-7811f23faf92_20250513T18:19_UTC.wav
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[AGENT][NEUTRAL] Afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII] [PII] and I have checked the claim status.
[AGENT][NEUTRAL] OK, [PII], you're needing to check claim status. Is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes, I can help you with that. And [PII], my name is [PII]
[AGENT][NEUTRAL] And what is your callback number, please?
[CUSTOMER][NEUTRAL] OK, [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Wait a moment. The callback number is
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And what is the member's policy number?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And first off, [PII], how many claims?
[CUSTOMER][NEUTRAL] Yeah, that was number ID number.
[AGENT][NEUTRAL] How many claims do you have to check status on?
[CUSTOMER][NEUTRAL] Uh, one claim.
[AGENT][NEUTRAL] OK, yes sir, and what is that member's policy number? I'm ready when you are.
[CUSTOMER][NEUTRAL] Yeah, that's my member ID number is 02363909.
[AGENT][POSITIVE] OK, thank you one moment please.
[AGENT][NEUTRAL] And any information that I do provide for you today, [PII] will be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth?
[CUSTOMER][NEUTRAL] Yeah. The patient's name is
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mm. [PII].
[CUSTOMER][NEUTRAL] How you spell that? [PII]
[CUSTOMER][NEUTRAL] [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] OK, so we have her last name as something different.
[AGENT][NEUTRAL] We do not have her last name as.
[CUSTOMER][NEUTRAL] Yeah, this is [PII].
[AGENT][NEUTRAL] I'm sorry, what was that last thing you said? OK. [PII] is how we have her listed.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And what is the um sorry, what is the date of service and total bill amount?
[CUSTOMER][NEUTRAL] Yeah. The date of service is [PII].
[AGENT][NEUTRAL] Mhm. And the total bill amount?
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Yes, wait a moment.
[CUSTOMER][NEUTRAL] Yeah, the total amount is $1,293.63.
[AGENT][NEUTRAL] I'm sorry, how many cents?
[AGENT][NEUTRAL] 1293.
[CUSTOMER][NEUTRAL] 1200.
[CUSTOMER][NEUTRAL] And 60, 63, 63 cents.
[AGENT][POSITIVE] 63. OK, thank you.
[AGENT][NEUTRAL] Just one moment.
[CUSTOMER][POSITIVE] No problem.
[AGENT][NEUTRAL] OK, so I do not have a claim on file, [PII], for this member for this state of service and that billed amount.
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] No claim on file for that bill amount?
[CUSTOMER][NEUTRAL] Yeah, the the amount is $1,293.63.
[AGENT][NEUTRAL] There is not a claim on file for AP with APL for that billed amount for this member.
[AGENT][NEUTRAL] We have not received a claim for that billed amount.
[CUSTOMER][NEUTRAL] Yeah, wait a moment.
[CUSTOMER][NEUTRAL] Yeah, there is a CVV code of [PII].
[AGENT][NEUTRAL] We do not have a claim on file for that CPT code.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Now when the claim, when you do submit the claim to us Cabin for review, you will need to include a copy of the primary insurance company's explanation of benefits as well because we because we must have that.
[AGENT][NEUTRAL] And then also once we have processed the claim, you can check claim status in our portal if you go to [PII].
[CUSTOMER][NEUTRAL] Uh, this, this is a claim note on file.
[AGENT][POSITIVE] That is correct. Correct.
[CUSTOMER][NEUTRAL] In this case,
[AGENT][NEUTRAL] But once you file the claim and when it has been processed, then you could check status in that portal.
[CUSTOMER][NEGATIVE] Yeah, they don't want.
[CUSTOMER][NEUTRAL] Yeah, the amount is $401.45.
[AGENT][NEUTRAL] No, sir. Not with APL.
[CUSTOMER][NEUTRAL] What is call reference number?
[AGENT][NEUTRAL] My my name and today's date.
[CUSTOMER][NEUTRAL] OK. You call the call reference number.
[AGENT][NEUTRAL] Hm
[AGENT][NEUTRAL] The call reference number is my name that I gave you along with today's date.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. Is there anything else, [PII] that I can help you with today?
[CUSTOMER][NEUTRAL] No, thank you.
[AGENT][POSITIVE] Alright, well, you're welcome and thank you for calling APL. I hope you have a nice day.