AccountId: 011433970860
ContactId: 0bac56aa-be24-48a5-8877-0c026a7d8055
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 308890 ms
Total Talk Time (AGENT): 89265 ms
Total Talk Time (CUSTOMER): 130280 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/25/0bac56aa-be24-48a5-8877-0c026a7d8055_20250325T15:16_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hello, uh, good morning. My name is [PII]. initial is [PII], and I'm calling from a provider's office to check on claims status for a member.
[AGENT][NEUTRAL] OK, sure, I can assist you with claim status, Mr. [PII]. May I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Hey
[CUSTOMER][NEUTRAL] Sure, it is [PII] and it's a direct line.
[AGENT][NEUTRAL] OK, thank you. What's the name of the facility for my notation?
[CUSTOMER][NEUTRAL] It's Breathe Free Sinus and Allergy Centers of Florida.
[AGENT][NEUTRAL] OK, thank you. And may I have the patient's policy number, Miss [PII]?
[CUSTOMER][NEUTRAL] Sure, one second, let me pull it up.
[CUSTOMER][NEUTRAL] Alright, I have here 02433.
[CUSTOMER][NEUTRAL] 121.
[AGENT][NEUTRAL] OK, may I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Sure. Uh, [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you. Alright, and what is the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] I have 21 2nd, let me pull it up.
[CUSTOMER][NEUTRAL] All right. Uh, both dates are for [PII].
[CUSTOMER][NEUTRAL] However, they have a different um
[CUSTOMER][NEUTRAL] Bill amount. The first one is for $505.
[CUSTOMER][NEUTRAL] The second is for $5559.94.
[AGENT][NEUTRAL] OK. Thank you. And you said they're both for [PII], correct?
[CUSTOMER][NEUTRAL] Yes. Um, I'm sorry, the second one is $1,443.79.
[AGENT][NEUTRAL] I don't have claims for that date of service. Um, yeah, the policy effective date was [PII] and it is active at the moment. That date of service is not in our system, so we have not received any claims.
[CUSTOMER][NEUTRAL] OK, one moment, let me just go ahead and check on with that.
[AGENT][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] But uh those claims should be uh sent directly to you guys right?
[AGENT][NEUTRAL] Mhm, yes.
[CUSTOMER][NEUTRAL] But let me just see, I think I saw a payment here from the other procedure.
[CUSTOMER][NEUTRAL] Let me just double check.
[AGENT][NEUTRAL] OK, sure.
[CUSTOMER][NEUTRAL] Oh, I see. That's why I think this was cross offered with uh Florida Blue.
[CUSTOMER][NEUTRAL] But let me just check.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And we don't do crossovers.
[CUSTOMER][NEUTRAL] Uh-huh, OK, and yeah.
[CUSTOMER][NEUTRAL] May I know the mail to address, please?
[AGENT][NEUTRAL] Yes, it's [PII] or [PII] Public [PII], and that's [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] The zip code is [PII].
[CUSTOMER][NEUTRAL] And yeah, if I may ask, what is the timely filing limit for a claim?
[AGENT][NEGATIVE] We don't have timely filing limits.
[CUSTOMER][NEUTRAL] OK, no you so.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Yeah, may I please have a uh call reference number please just for my notes.
[AGENT][NEUTRAL] We don't have reference numbers you can use my name in today's date if you will.
[CUSTOMER][POSITIVE] OK cool thank you so much.
[AGENT][POSITIVE] You're welcome. Is there anything else I can help you with today?
[CUSTOMER][POSITIVE] No, we're all set. Thank you.
[AGENT][POSITIVE] Thank you. You're welcome and thank you for calling APO. Have a good day.