AccountId: 011433970860
ContactId: 0e8c2f3d-777f-4ae2-813b-0b04f9203c3f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 628630 ms
Total Talk Time (AGENT): 220053 ms
Total Talk Time (CUSTOMER): 173681 ms
Interruptions: 4
Overall Sentiment: AGENT=0.7, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/09/0e8c2f3d-777f-4ae2-813b-0b04f9203c3f_20250409T19:53_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yeah, hi. My name is uh [PII]. I'm calling from provider office. Last name of initially is G as in golf.
[AGENT][NEUTRAL] Hi, you said your first name is [PII]. Is that correct?
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Yes, correct. Yes, correct. Please spell your name is.
[AGENT][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Yeah, I'm there fully, are you hear me?
[AGENT][NEUTRAL] Yes, [PII], I can hear you.
[AGENT][NEUTRAL] My name is [PII]. It is spelled [PII], [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Well
[CUSTOMER][POSITIVE] Yeah, got it. Thank you, [PII].
[AGENT][NEUTRAL] OK. You're welcome. And what is your callback number, please, [PII]?
[CUSTOMER][NEUTRAL] Uh, my callback number is [PII].
[AGENT][NEUTRAL] Thank you. And how many claims, [PII], do you put claim status on?
[CUSTOMER][NEUTRAL] Uh, I have to claim here.
[AGENT][NEUTRAL] OK. Are your, are your two claims for the same patient or for different patients?
[CUSTOMER][NEUTRAL] Uh, just one second. Uh, I have 3 claims here. Uh, it is a different version.
[AGENT][NEUTRAL] So you have 3 different patients in each.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] You has one data service, is that correct?
[AGENT][NEUTRAL] OK, yes sir, I can help you with that and [PII] you will use my name that I gave you along with today's date as your call reference number for each one.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Also, [PII], any information that I provide for you today will be a verification of benefits and not a guarantee of payment.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And lastly, if we do have the claims on file of the explanation of benefits, you may print those by going to our portal which is located at [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] All right. And what is your first patient's policy number, please?
[CUSTOMER][NEUTRAL] Policy number is 018.
[CUSTOMER][NEUTRAL] 854
[CUSTOMER][NEUTRAL] 50
[CUSTOMER][NEUTRAL] M as in Mike. L as in Lima, number 7.
[AGENT][NEUTRAL] So you said 01885450. Is that correct? Before the ML?
[CUSTOMER][POSITIVE] Yes, correct.
[CUSTOMER][NEUTRAL] 77 after that email.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, thank you. And what is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] Uh, name of the patient is, uh,
[CUSTOMER][NEUTRAL] Uh, just give me, sir. [PII], and date of birth is [PII].
[AGENT][NEUTRAL] Thank you. And what's the date of service and total bill amount, please?
[CUSTOMER][NEUTRAL] Uh, date of service is uh [PII] with the bill amount is uh $250 you want.
[AGENT][NEUTRAL] OK, so first off, you said the dental service is 210 of [PII]. Is that correct?
[CUSTOMER][POSITIVE] Yes, correct.
[AGENT][NEUTRAL] OK, so I need to give you a new policy number for this number.
[AGENT][NEUTRAL] Because the policy number that you provided for me for the data service, the policy number you gave me was active from [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] To its term date of [PII].
[AGENT][NEUTRAL] And the policy that is active for your date of service is policy number 248.
[AGENT][NEUTRAL] E
[AGENT][NEUTRAL] 631-3.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And that policy, Charles has an effective date of [PII].
[AGENT][NEUTRAL] So give me just a moment to pull that policy information up so I can see if we've received your claim.
[CUSTOMER][NEUTRAL] Yeah, sure.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] We then what
[CUSTOMER][NEUTRAL] A
[CUSTOMER][NEUTRAL] Just.
[AGENT][NEUTRAL] OK, and again for data service 210-2025, we do not have a claim on file for this member at this time.
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] OK. So we need to submit the claim with primary UB actually is the crossover claim. Uh, USC United Healthcare Choice, uh, leveled transfer this claim to the American public by life. Could you please provide me the fax number?
[AGENT][NEUTRAL] 8
[AGENT][NEUTRAL] [PII] attention claims.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm. Uh, there is any mailing address to submit the claim with primary OV?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] right
[AGENT][NEUTRAL] And the zip code is [PII].
[CUSTOMER][NEUTRAL] Uh, could you please confirm that it is a [PII]. That is correct?
[AGENT][POSITIVE] That is correct.
[AGENT][NEUTRAL] In [PII].
[CUSTOMER][NEUTRAL] OK. And timely time limit to submit the
[AGENT][NEGATIVE] There is no timely filing, yes, no timely filing limit.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I got it.
[CUSTOMER][NEUTRAL] OK, sure.
[CUSTOMER][NEUTRAL] Uh, OK. And call reference number is your name and two digit. OK, I'm done for that, ma'am. Can you move from the reup patient ID?
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, and the next patient's policy number?
[CUSTOMER][NEUTRAL] Next question policy number is 024.
[CUSTOMER][NEUTRAL] 50175.
[AGENT][NEUTRAL] That was 02450175. Is that correct, [PII]?
[CUSTOMER][POSITIVE] Yes, correct.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And your patient's name, please, and date of birth?
[CUSTOMER][NEUTRAL] Uh, name of the patient is [PII] and date of birth is [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And the date of service and total bill amount, please.
[CUSTOMER][NEUTRAL] Uh, date of service is uh [PII]. It will amount to the $350 even.
[AGENT][NEUTRAL] OK, that was
[AGENT][NEUTRAL] Day the service [PII], is that correct?
[CUSTOMER][POSITIVE] Yes, correct.
[AGENT][NEUTRAL] OK. Also, there is no claim on file for this member.
[CUSTOMER][NEUTRAL] OK. Uh, actually, the next member is the same but date of services are different.
[AGENT][NEUTRAL] But it's a different number, is that correct?
[CUSTOMER][NEUTRAL] No, same, same member date of service is different.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] OK, and what is the next date of service?
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] Total bill amount.
[CUSTOMER][NEUTRAL] $480 even.
[AGENT][POSITIVE] Thank you. One moment.
[AGENT][NEUTRAL] And there is no claim on file for that date of service either.
[CUSTOMER][POSITIVE] Uh, OK, [PII]. Thank you for assisting me. I'm done with all the members here.
[AGENT][POSITIVE] Well, you're welcome.
[AGENT][NEUTRAL] You
[CUSTOMER][NEUTRAL] Yeah bye bye.
[AGENT][POSITIVE] You're welcome. So is there anything else that I could help you with today?
[CUSTOMER][POSITIVE] Have a good day.
[CUSTOMER][POSITIVE] No, I'm done for the member. Thank you.
[AGENT][NEUTRAL] OK, [PII], well if that's all I can help you with.
[CUSTOMER][NEUTRAL] Mhm bye.
[AGENT][POSITIVE] You're welcome and thank you again for calling APL. I hope you have a