AccountId: 011433970860
ContactId: 0dbde419-cbe4-43e0-aa23-7aae6ebb0ee5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 310880 ms
Total Talk Time (AGENT): 135717 ms
Total Talk Time (CUSTOMER): 142134 ms
Interruptions: 9
Overall Sentiment: AGENT=2, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/21/0dbde419-cbe4-43e0-aa23-7aae6ebb0ee5_20250221T14:14_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII]. My name is [PII] calling from provider's office to check on claims.
[AGENT][NEUTRAL] OK, [PII], you're needing claim status, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Yes, I can help you with that and what is your callback number?
[CUSTOMER][NEUTRAL] Callback number is [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Thank you, and [PII], how many claims do you have to check status on today?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Two claims for the same patient. Yes.
[AGENT][NEUTRAL] OK, for the same number, uh just two different dates of service.
[CUSTOMER][NEUTRAL] Um, date of service, it would be mm.
[AGENT][NEUTRAL] No, no, no. OK, no, no, ma'am. You said the same patient for 2 dates of service, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Yes, I can help you and [PII], you will use my name that I gave you along with today's date as your call reference number. Also any information that.
[CUSTOMER][NEUTRAL] Could you please spell your name, [PII]?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] And any information that I provide today will be a verification of benefits and not a guarantee of payment. And lastly, here, if we do have the claims on file and you need a copy of the explanation of benefits, you may print that from our portal at [PII].
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Right
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so what is your patient's policy number?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] It's 01761792.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Thank you one moment.
[CUSTOMER][NEUTRAL] Hello
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] Really
[CUSTOMER][NEUTRAL] I got
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And [PII], what is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Member's name is [PII]. Date of birth is [PII].
[CUSTOMER][NEUTRAL] Yeah
[AGENT][POSITIVE] Thank you and the date of service and total build amount please.
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] It is [PII] with the billed amount of $214 even.
[AGENT][NEUTRAL] Again that was 324-2023 for 214, is that correct?
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] Correct.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, there is no claim on file for him for data service 324-2023.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Could you please verify the members effective dates?
[AGENT][NEUTRAL] Effective date is [PII], term date [PII].
[CUSTOMER][NEUTRAL] Thank you. Can I get the timely filing limit?
[AGENT][NEGATIVE] There is no timely filing limit?
[CUSTOMER][NEUTRAL] Can I get the mailing address?
[AGENT][NEUTRAL] Where you must
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] one.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I'm sorry, it's [PII], uh, zip code would be?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][POSITIVE] [PII]. OK, thank you so much. Uh, sure.
[AGENT][NEUTRAL] And you will also need to submit a copy of the primary insurance company's explanation of benefits along with the claim.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yes. Thank you. Can I get the, uh, Sheldon wanted the next date of service for the same patient?
[AGENT][POSITIVE] Yes, ma'am, you can.
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] It's $511 even.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, there is no claim on file for this number for that data service.
[CUSTOMER][POSITIVE] OK, thank you so much, [PII], for your assistance. That's all for today.
[AGENT][POSITIVE] You're very welcome.
[AGENT][POSITIVE] OK, well if that's all I can help you with, and thank you again for calling APL and I hope you have a nice weekend, [PII].
[CUSTOMER][POSITIVE] Thank you. Bye for now, [PII]. Thank you.
[AGENT][POSITIVE] Uh-huh. You're welcome. Thank you. Bye-bye.
[CUSTOMER][NEUTRAL] Bye.