AccountId: 011433970860
ContactId: 0910dc09-d049-4e98-a0db-1ed261b6da5d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 614099 ms
Total Talk Time (AGENT): 199125 ms
Total Talk Time (CUSTOMER): 196033 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/07/0910dc09-d049-4e98-a0db-1ed261b6da5d_20250307T16:04_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Um, hello, this is you from office. How are you doing?
[AGENT][POSITIVE] I'm doing well today. Can you please uh repeat your name for me?
[CUSTOMER][NEUTRAL] Um, yes, it's [PII]. Um I will spell that for you. It's going to be [PII]
[CUSTOMER][NEUTRAL] And initial, my last name is [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][POSITIVE] OK, thank you, [PII]. I appreciate you spelling that for me. How can I help you today?
[CUSTOMER][NEUTRAL] Um, I just want to check, uh, claim status, and, um, I need with the like, um, some information with the claim submissions like how can we submit claims.
[AGENT][NEUTRAL] Yes sir, I can help you with both. Um, I can get the status of the claim for you and give you our, our claim address. Um, [PII], what is your callback number just in case our call gets disconnected?
[CUSTOMER][NEUTRAL] Um, the callback number is going to be [PII].
[AGENT][NEUTRAL] Thank you sir. And then what is the name of the patient, the date of birth, and the policy number?
[CUSTOMER][NEUTRAL] I'm sorry, uh, your voice is getting corrupt. Can you repeat that for me?
[AGENT][NEUTRAL] Uh, can you please give me the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Yes, uh, patient name is [PII] uh, I'm sorry, [PII], and the policy number is 02337119.
[AGENT][NEUTRAL] OK and um patient's date of birth?
[CUSTOMER][NEUTRAL] It's going to be [PII].
[AGENT][NEUTRAL] OK, let me look up that policy number for us real quick.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, and what is the date of service of the claim?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the charge amount please?
[CUSTOMER][NEUTRAL] $56 even.
[AGENT][NEUTRAL] OK, and then what is the charge amount after the primary insurance paid their part?
[CUSTOMER][NEUTRAL] It's $26.59.
[AGENT][NEUTRAL] Thank you. And then what is the name of the facility you're calling for Uriel?
[CUSTOMER][NEUTRAL] It's CMS diagnostic services.
[AGENT][NEUTRAL] OK, I'm gonna put you on a quick hold while I look up this claim for you and I will be right back.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Um, OK, no problem. You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK, you're well, thank you for holding for me. So looking on the data service.
[AGENT][NEUTRAL] Of
[AGENT][NEUTRAL] [PII], I do not find a claim on file.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So the address to send the claim to.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] Is APL claims.
[CUSTOMER][POSITIVE] I'm, I'm sorry.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] IPO claims.
[AGENT][NEUTRAL] That's [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] I'm sorry, just one second.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] And that's in [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] [PII], right?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And that's in the state is also [PII].
[CUSTOMER][NEUTRAL] Um-hum.
[AGENT][NEUTRAL] And then the zip code is [PII].
[CUSTOMER][NEUTRAL] Um, I'm sorry, can you repeat that?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Um, thank you very much for that. Um, can we also submit the claims through fax?
[AGENT][NEUTRAL] Yes, let me give you the fax number.
[CUSTOMER][POSITIVE] Mhm thank you very much for that also.
[AGENT][NEUTRAL] That's one.
[AGENT][NEUTRAL] You're welcome. That's 1877.
[AGENT][NEUTRAL] 365.
[AGENT][NEUTRAL] 942 3.
[CUSTOMER][NEUTRAL] Um, can you provide me the electronic payroll ID also?
[AGENT][NEUTRAL] Yes, that is 6.
[AGENT][NEUTRAL] 0801.
[CUSTOMER][NEUTRAL] Um, 60801, right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Um, thank you very much. Um, moving back, back to the claim, can you let me know the claim status? Is it paid or denied?
[AGENT][NEUTRAL] The claim is not on file.
[AGENT][NEUTRAL] It's not we don't have on file.
[CUSTOMER][NEUTRAL] Um, uh
[CUSTOMER][NEUTRAL] Um, OK, I, sorry, I thought you said the claim is on file. I'm sorry for that.
[AGENT][NEUTRAL] No, sir. I, no, that's OK.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Mhm. Um, can you provide me the reference number? Is there any and uh spell out your good name for me?
[AGENT][NEUTRAL] Is there, um, I'm sorry, can you repeat the question?
[CUSTOMER][NEUTRAL] Yeah, uh, I was asking about the cora number but is there any, on, um, and can you spell your good name for me?
[AGENT][NEUTRAL] Yes, um, call reference would be my name [PII]
[AGENT][NEUTRAL] My last initial is [PII]
[AGENT][NEUTRAL] And today's date.
[CUSTOMER][NEUTRAL] I'm, I'm sorry, I missed that. I, I missed the, I missed your name. Can you repeat that?
[AGENT][NEUTRAL] Yes, it's [PII]
[AGENT][NEUTRAL] Last initial is A.
[CUSTOMER][POSITIVE] [PII], yes.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] And then today's today.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][POSITIVE] Alright, alright, I got it. Sorry, thank you very much for that.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][POSITIVE] Mm, um, thank you very much for your.
[AGENT][NEUTRAL] Is there anything else I can help you with today, [PII]?
[CUSTOMER][POSITIVE] Um, no, that's all for today. Thank you very much for your time and concern.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, uh, can you like, uh, I'm, I'm sorry, I missed like the participating status of the provider with the insurance. Can you let me know like it's in network or out of network?
[AGENT][POSITIVE] You're very welcome I.
[AGENT][NEUTRAL] Uh-huh
[AGENT][NEUTRAL] Uh, there's not a network for this policy.
[AGENT][NEUTRAL] It's a secondary insurance.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] And uh can you like let me know the timely filing for the submission of new claims, corrected claims, and for appeal and documentation.
[AGENT][NEGATIVE] For new claims, there is no timely filing limit.
[AGENT][NEUTRAL] For appeal is 180 days from the date the claim initially was processed.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And you'll need a letter while you're appealing.
[AGENT][NEUTRAL] And then for claims correction there's no time limit, but you need a letter why it needs to be corrected.
[CUSTOMER][POSITIVE] Um, I got it. Thank you very much for, um, sorry uh that information also.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][POSITIVE] OK, have a great rest of the day. Bye bye for now. Thank you very much once again.
[AGENT][POSITIVE] You have a wonderful weekend, [PII], and thank you for calling APL. Bye bye, sir.
[CUSTOMER][NEUTRAL] Yeah