AccountId: 011433970860
ContactId: 0e737fe7-ad70-4a88-b126-40a11c2a2288
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 572900 ms
Total Talk Time (AGENT): 254126 ms
Total Talk Time (CUSTOMER): 144752 ms
Interruptions: 3
Overall Sentiment: AGENT=1, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/23/0e737fe7-ad70-4a88-b126-40a11c2a2288_20250623T12:51_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, my name is [PII] calling from the product's office to check on the claim status.
[AGENT][NEUTRAL] OK, [PII], you're needing claim status, is that correct?
[CUSTOMER][POSITIVE] Yes, correct.
[AGENT][POSITIVE] Yes, [PII], I can help you with that. And what is a good callback number for you, please?
[CUSTOMER][NEUTRAL] Sure. The callback number will be
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And how many claims, [PII], do you have to check status on?
[CUSTOMER][NEUTRAL] I have two claims for the same member ID.
[AGENT][NEUTRAL] OK, I can help you with both and [PII] you will use my name that I gave you along with today's date as your call reference number for each one. Also, any information that is provided will be a verification of benefits and not a guarantee of payment. And then lastly.
[AGENT][NEUTRAL] If we do have the claims on file and you need a copy of the explanation of benefits, then you may print those by going to our portal once you have the claim number at secured. [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] All right, so just one moment please.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And what is your patient's policy number, please, [PII]?
[CUSTOMER][NEUTRAL] It will be 02465000. M as in Mike, L as in Lima, and 8.
[AGENT][POSITIVE] Thank you one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And like, again, any information provided will be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] The patient's name will be Ms [PII].
[CUSTOMER][NEUTRAL] And the date of birth will be [PII].
[AGENT][NEUTRAL] OK, what is the date of birth again?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And what is the first day of service and total bill amount?
[CUSTOMER][NEUTRAL] The rate of service will be [PII], and the total bill amount will be
[AGENT][NEUTRAL] April what day? No, no, no, April what day?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the year?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Uh-huh. OK. And the bill the mail.
[CUSTOMER][NEUTRAL] It will be $193 even.
[AGENT][POSITIVE] Thank you one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so for data service [PII], we do not have a claim on file for this member.
[AGENT][NEUTRAL] And because this is a supplemental policy, [PII] to the primary insurance, when the claim is submitted to us for review, we will have to have a copy of the primary insurance company's explanation of benefits along with the claim for review.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. May I know the payer ID?
[AGENT][NEUTRAL] 60801.
[CUSTOMER][NEUTRAL] OK. May I know the mailing address?
[AGENT][NEUTRAL] The same, which address do you show for claims?
[CUSTOMER][NEUTRAL] [PII], right?
[AGENT][NEUTRAL] OK, so that is an old PO box. It's no longer valid. The correct [PII] box that you should have is [PII].
[AGENT][NEUTRAL] That's [PII] City, [PII].
[AGENT][NEUTRAL] And the zip code is [PII].
[CUSTOMER][NEUTRAL] OK. We should resubmit the claim to this mailing address, right?
[AGENT][NEUTRAL] Along with the primary insurance company's explanation of benefits.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And you said that you had another data service for this number also?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, before that, may I know the effective date and the term date for this claim?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] This supplemental policy is active, effective [PII], and there is no termination date.
[CUSTOMER][NEUTRAL] OK. May I know the timely filing limit to submit the claim?
[AGENT][NEUTRAL] No timeline filing limits?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEGATIVE] There is no.
[AGENT][NEUTRAL] Timely filing limit.
[CUSTOMER][NEUTRAL] OK. And could you please spell out your name for documentation purpose?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] OK. And can we move on to the next another claim?
[AGENT][POSITIVE] Yes, we can.
[CUSTOMER][NEUTRAL] OK, just a minute.
[AGENT][NEUTRAL] It's for the same member, that's what you said. Is that correct? Just another data service.
[CUSTOMER][POSITIVE] Yeah, got it.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] And the date of service will be [PII].
[CUSTOMER][NEUTRAL] And the total bill amount will be $299 even.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And there is also no claim on file for that data service.
[AGENT][NEUTRAL] And we would need the same information as what I've given you.
[CUSTOMER][NEUTRAL] OK, for this one.
[CUSTOMER][NEUTRAL] OK. Uh, this one also the mailing address and the pay ID is the same, right?
[AGENT][POSITIVE] Everything is the same. That is correct.
[CUSTOMER][NEUTRAL] May I know the effective date and the time to date for this claim?
[AGENT][NEUTRAL] Yes, sir. I just gave you the effective date on this policy.
[CUSTOMER][NEUTRAL] OK, sure. And for this claim also, there's no TFL, right?
[CUSTOMER][NEUTRAL] Time limit.
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And before you say that the call reference number will be your name on the today's date, right?
[AGENT][NEUTRAL] That is correct. And again, once we have received and processed these claims, we do have that portal that you should be able to check claim status in and the website again for that is secured.
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] OK, sir.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK. One more time, could you please verify the mailing address you provided. It's [PII].
[AGENT][NEUTRAL] Uh.
[AGENT][NEUTRAL] Yes, sir.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] No, it's [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Well, look, no, it's [PII].
[CUSTOMER][NEUTRAL] Could you please spell out that?
[AGENT][NEUTRAL] OK, the city name is two words.
[CUSTOMER][NEUTRAL] Could you please spell that?
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] The next word is [PII]
[AGENT][NEUTRAL] The state is [PII].
[AGENT][NEUTRAL] The zip code is [PII].
[CUSTOMER][POSITIVE] OK, sure. Thank you for that.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] And is there anything else, [PII], I can help you with?
[CUSTOMER][NEUTRAL] OK. That's it for this claim.
[CUSTOMER][POSITIVE] Yeah, that's it for these claims. And thank you for your kind assistance and have a nice day.
[AGENT][POSITIVE] I hope you have a nice day too, [PII], if that is all I can help you with, and thank you again for calling APL.
[CUSTOMER][NEUTRAL] Bye.
[AGENT][POSITIVE] Uh-huh, thank you. Bye bye.