AccountId: 011433970860
ContactId: 09b2d0cf-6f3b-4bbe-85b4-231cb6154c78
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 276100 ms
Total Talk Time (AGENT): 116060 ms
Total Talk Time (CUSTOMER): 163098 ms
Interruptions: 10
Overall Sentiment: AGENT=0.8, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/05/09b2d0cf-6f3b-4bbe-85b4-231cb6154c78_20250205T19:28_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] When you
[CUSTOMER][NEUTRAL] Um, hi, this is [PII] calling from the provider's office to check on status.
[AGENT][NEUTRAL] OK, [PII], are you needing claim status?
[CUSTOMER][NEUTRAL] Um, you said your name is [PII], right?
[CUSTOMER][NEUTRAL] Claim status? Yes.
[AGENT][NEUTRAL] Yes, my name is [PII] And yes, [PII], I can help you with claim status. What is your callback number?
[CUSTOMER][NEUTRAL] Yes, my name is [PII] or [PII]. OK, yes, I, I can help you with my status. What is your callback number? [PII] and it's a direct line.
[AGENT][NEUTRAL] Thank you. And how many claims do you have to check status on, [PII]?
[CUSTOMER][NEUTRAL] Like, you have to check the status on with? Um, only one.
[AGENT][NEUTRAL] OK. And what is that member's policy number, please?
[CUSTOMER][NEUTRAL] And what is that member's policy number, please? It is.
[CUSTOMER][NEUTRAL] 02359305
[AGENT][POSITIVE] Thank you, one moment.
[CUSTOMER][POSITIVE] Thank you one moment. Mhm.
[AGENT][NEUTRAL] And any information [PII] that I do provide for you today would be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] Information like this that I do for you today would be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth? name was [PII]. Date of birth of [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And what is the date of service and total bill amount, please?
[CUSTOMER][NEUTRAL] I build out, please.
[CUSTOMER][NEUTRAL] Date of service is number [PII]. The bill amount is $247 even.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And again you said data services [PII] for $247. Is that correct?
[CUSTOMER][NEUTRAL] And you could say the service is [PII] paying the $2047 is that correct?
[AGENT][NEUTRAL] OK, we do not have a claim on file for him for that data of service and that total bill amount.
[CUSTOMER][NEUTRAL] OK, we do not have a place on file.
[CUSTOMER][NEUTRAL] For that is the service you get that total bill amount.
[AGENT][NEUTRAL] And because this is a supplemental policy, [PII] to his primary insurance.
[CUSTOMER][NEUTRAL] So maybe it'll be a supplemental policy I said.
[AGENT][NEUTRAL] You will also need to include a copy of the primary insurance company's explanation of benefits with the claim for a review.
[CUSTOMER][NEUTRAL] Primary insurance?
[CUSTOMER][NEUTRAL] You will also need to include a copy of the primary insurance company's explanation of benefits with the claim for our review.
[CUSTOMER][NEUTRAL] Mhm. OK, so may I know the patient's uh eligibility?
[AGENT][NEUTRAL] The policy is active with an effective date of [PII].
[CUSTOMER][NEUTRAL] The policy is active with an effective date of [PII].
[CUSTOMER][NEUTRAL] Still active, right?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][POSITIVE] That is correct. Mhm. OK.
[AGENT][NEUTRAL] And then once we have processed our claim here at APL, we do have a portal that you can check claim status in Lisa by going to secured. Ampublic.
[CUSTOMER][NEUTRAL] And then once we have processed our claim here at HBO, we do have a portal that you can check claim status in Lisa by going to secure.
[CUSTOMER][NEUTRAL] A um public.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Thank you so much and also may I know the payer ID to submit a claim?
[AGENT][NEUTRAL] 60801.
[CUSTOMER][NEUTRAL] 60801.
[AGENT][NEUTRAL] And again we do have to have a copy of his primary insurance explanation of benefits as well. There is no timely filing limit.
[CUSTOMER][NEUTRAL] And the timely filing limit, we do have to have a copy of your primary insurance explanation of benefits as well. There is a timely filing limit. Is it possible to confirm who is the primary for this number?
[AGENT][NEUTRAL] Per our records for his employer, it's Blue Cross and Blue Shield, and that is the only information I have and you would have to reach out to the member for any detailed information on his primary.
[CUSTOMER][NEUTRAL] For our records for his employer at Blue Cross and Bluefield, and that is the only information I have, and you would have to reach out to the member for any details, any information on his primary. OK, so that's it for the details. Thank you so much for assisting me. May I know the reference number for our conversation?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] My name and today's date?
[CUSTOMER][NEUTRAL] My name in today's date.
[CUSTOMER][POSITIVE] Thank you so much and you may have a wonderful rest of the day. Bye-bye.
[AGENT][POSITIVE] I hope you did your [PII], and that's all I can help you with. Thank you again for calling APL.
[CUSTOMER][POSITIVE] I hope you did to [PII] and that's all I can help you with. Thank you again for calling APL. Take care bye bye.
[AGENT][NEUTRAL] Ah, you too.