AccountId: 011433970860
ContactId: 0e17e7b1-d8d3-42be-b12e-f2f82a708d99
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 347989 ms
Total Talk Time (AGENT): 122394 ms
Total Talk Time (CUSTOMER): 116459 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/03/0e17e7b1-d8d3-42be-b12e-f2f82a708d99_20250203T19:55_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Oh hi, this is [PII] from the provider's office to check on the claim status. Could you please spell your name?
[AGENT][NEUTRAL] It's spelled [PII] and my last initial is [PII].
[CUSTOMER][NEUTRAL] Yes, your name is [PII], [PII]
[AGENT][NEUTRAL] No, it's [PII], um, it's [PII] and my last initial is [PII].
[CUSTOMER][POSITIVE] Sure. Thank you, [PII]
[AGENT][POSITIVE] No problem, [PII]. Could I get a good callback number just in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes, the callback number, just a moment. Yes, it's [PII]. No extension.
[AGENT][NEUTRAL] Thank you. Now, I need the policy number, please.
[CUSTOMER][NEUTRAL] So, the policy number 22.
[CUSTOMER][NEUTRAL] 01664.
[AGENT][NEUTRAL] Please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Patient's name is [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] OK. And do you need to verify benefits or do you need the status of a claim?
[CUSTOMER][NEUTRAL] Yes, uh, status and denial of the claim.
[AGENT][NEUTRAL] OK, sure. And what's the date of service and bill charges on the claim?
[CUSTOMER][NEUTRAL] Sure
[CUSTOMER][NEUTRAL] Yes, the date of service is [PII].
[CUSTOMER][NEUTRAL] And the bill amount is just a moment.
[CUSTOMER][NEUTRAL] 1884884.
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][POSITIVE] Take your time.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And please repeat that date of service, you said [PII]?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] OK. Do you have a claim number? Because I'm not showing a claim on file for that date of service.
[CUSTOMER][NEUTRAL] No, I don't have the claim number from my side.
[AGENT][NEUTRAL] OK. OK, one moment. I do show that.
[CUSTOMER][NEUTRAL] May I know the pay ID?
[AGENT][NEUTRAL] Um, I do show that one claim is pending. One moment, let me check the date of service on that claim. One moment, please.
[CUSTOMER][POSITIVE] Mhm. Sure, sure. Take your time.
[AGENT][POSITIVE] Thanks.
[AGENT][NEUTRAL] OK. No, sir. I'm not showing that claim on file.
[CUSTOMER][NEUTRAL] Sure. May I know the payer ID?
[AGENT][NEUTRAL] The payer ID is 60801.
[CUSTOMER][NEUTRAL] 60
[AGENT][NEUTRAL] Mhm. 60801.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Sure, uh, so from your end, there is no claim on file, right?
[AGENT][NEUTRAL] Right, not with that date of service.
[CUSTOMER][NEUTRAL] Sure, date of service [PII] and the bill amount for $95.
[AGENT][NEUTRAL] Right, no claims on file with that information.
[CUSTOMER][NEUTRAL] Sure, I got it because we submitted on, just a moment.
[CUSTOMER][NEUTRAL] Because we submitted on [PII] electronically for the payer ID 01 06126.
[AGENT][NEUTRAL] OK. No, sir. That's not our payer ID.
[CUSTOMER][NEUTRAL] Sure. May I know the mailing address?
[AGENT][NEUTRAL] The mailing address is [PII].
[AGENT][NEUTRAL] And that's in [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] You ready? um [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And the zip code is [PII].
[CUSTOMER][NEUTRAL] Sorry, could, could you please uh repeat the [PII]?
[AGENT][NEUTRAL] Yes, it's [PII].
[CUSTOMER][NEUTRAL] Sure, got it. Uh may I know the effective date of this claim?
[AGENT][NEUTRAL] Um yes, and just let me advise you the verification of coverage does not guarantee payment of claims. The effective date on this policy was [PII], and the policy is still active.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] I'm still I'm still active.
[AGENT][NEUTRAL] Yes, and it's still active.
[CUSTOMER][NEUTRAL] Sure, got it. So we have to submit to this uh payer ID 60801, uh, the effective date and termination date. So from your end, there is no claim on file, right?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] Sure, I got it. Just a moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] May I know the call reference?
[AGENT][NEUTRAL] So the reference number, you can use my name and today's date. Is there anything else that I can assist you with?
[CUSTOMER][NEUTRAL] Just a moment.
[CUSTOMER][POSITIVE] Yes, sir, thank you for your assistance. Have a wonderful day.
[AGENT][NEUTRAL] You do the same, [PII]. Thank you for calling APL. Mm bye.