AccountId: 011433970860
ContactId: 0f84489e-83ea-48e4-ae81-ef6dc927772a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 251270 ms
Total Talk Time (AGENT): 107622 ms
Total Talk Time (CUSTOMER): 55339 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/07/0f84489e-83ea-48e4-ae81-ef6dc927772a_20250107T16:18_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] Yeah.
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII]. I'm calling from provider's office, checking our claim status.
[AGENT][NEUTRAL] OK [PII], you're needing claim status, is that correct?
[CUSTOMER][NEUTRAL] Yes, right.
[AGENT][POSITIVE] Yes, I can help you with that. And what is your callback number, please?
[CUSTOMER][NEUTRAL] Callback phone number is [PII]. It's a direct line.
[AGENT][POSITIVE] Thank you and [PII], how many claims do you have today?
[CUSTOMER][NEUTRAL] No
[CUSTOMER][NEUTRAL] Only one claim.
[AGENT][NEUTRAL] OK, um, and what is that member's policy number, please?
[CUSTOMER][NEUTRAL] 01893988.
[AGENT][POSITIVE] Thank you one moment please.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] And any information [PII] that I provide for you today will be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth, please?
[CUSTOMER][NEUTRAL] The first name is [PII]. Last name is.
[CUSTOMER][NEUTRAL] [PII]. Date of birth [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] And any information, [PII], that I do provide will be a verification of benefits and not a guarantee of payment. What is the date of service and total bill amount for the patient, please?
[CUSTOMER][NEUTRAL] Date of service is [PII] and the bill amount is $503 even.
[AGENT][POSITIVE] Thank you, one moment.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And again, the date of service you said is [PII], is that correct?
[CUSTOMER][NEUTRAL] Yeah, right.
[AGENT][NEUTRAL] OK, we do not have a claim on file for this member for the state of service and total bill amount.
[CUSTOMER][NEUTRAL] OK. How much is the timely filing to submit the claim?
[AGENT][NEGATIVE] There is no timely filing.
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEGATIVE] There is no timely filing limit.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] OK. What's the membership effective date and the term date?
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] This policy was active from [PII] to its term date of [PII].
[CUSTOMER][NEUTRAL] OK, so the member was not active on the date of service?
[AGENT][NEUTRAL] That is correct. Let me see if there was another policy by chance that was active one moment.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Uh no, sir, there was not. We have not had a, he has not had another policy with us since that time.
[CUSTOMER][NEUTRAL] OK, no problem. Uh, can I
[CUSTOMER][NEUTRAL] Can I get the call reference number?
[AGENT][NEUTRAL] Yes sir, you would use my name along with today's date.
[CUSTOMER][NEUTRAL] Can I get your name?
[AGENT][NEUTRAL] Again, my name is [PII] and the first initial to my last name is [PII].
[CUSTOMER][POSITIVE] OK, [PII]. Thanks for the information. You are great. Thank you. Bye-bye.
[AGENT][POSITIVE] Yes, sir. I, uh, you're very welcome, [PII], and if that's all I can help you with, thank you again for calling APL and I hope you have a nice day also.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] bye bye.
[AGENT][NEUTRAL] Um, bye-bye.