AccountId: 011433970860
ContactId: 0fdc12e0-d6d8-4252-9019-6e5947b30b8a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 347459 ms
Total Talk Time (AGENT): 169814 ms
Total Talk Time (CUSTOMER): 136210 ms
Interruptions: 4
Overall Sentiment: AGENT=0.3, CUSTOMER=1.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/05/0fdc12e0-d6d8-4252-9019-6e5947b30b8a_20250505T17:46_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII]. Very happy, good afternoon to you. This is [PII], and my first and last name is your first name, [PII], and I'm calling from the provider's office and looking for a client insurance for this calls, [PII].
[AGENT][NEUTRAL] OK, you said your name is [PII]. Is that correct?
[CUSTOMER][NEUTRAL] OK, yes.
[AGENT][NEUTRAL] And you have one claim that you need to check status on, is that also correct?
[CUSTOMER][POSITIVE] Yes, yes, of course.
[AGENT][NEUTRAL] Yes, sir, I can help you with that and [PII], what is your callback number?
[CUSTOMER][POSITIVE] Yes, right, very good callback number [PII] and my ex is [PII].
[AGENT][NEUTRAL] [PII] is your extension.
[CUSTOMER][NEUTRAL] Yes. Mhm.
[AGENT][NEUTRAL] OK, thank you. And what is the member's policy number, please, [PII]?
[CUSTOMER][NEUTRAL] So the number ID number is going to be 01802609.
[AGENT][NEUTRAL] OK, thank you. One moment please while I get the member's information pulled up.
[CUSTOMER][POSITIVE] Oh, great, take some about this.
[AGENT][NEUTRAL] OK, and [PII], any information that I provide for you today would be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] So a patient named [PII], member's date of birth [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And the date of service and total bill amount, please.
[CUSTOMER][NEUTRAL] Welcome.
[CUSTOMER][NEUTRAL] The date of service is going to be [PII]. For [PII], the total charge amount would be the amount of $62 and even.
[AGENT][NEUTRAL] And you said data services [PII] for $62. Is that correct?
[CUSTOMER][POSITIVE] Yeah, that's right you got it.
[AGENT][NEUTRAL] OK, so there is no claim on file for this member for that data service.
[CUSTOMER][NEUTRAL] OK, there is no claim on file. OK. And what about the member and termination date?
[AGENT][POSITIVE] That's great.
[AGENT][NEUTRAL] The effective date on this plan is [PII] term date [PII].
[CUSTOMER][NEUTRAL] [PII]. OK, so what about the claim commission time refilling limit?
[AGENT][NEGATIVE] There is no timely filing limit.
[CUSTOMER][NEUTRAL] OK, so there is no time limit for American public life, OK.
[AGENT][NEUTRAL] But we
[AGENT][NEUTRAL] That is correct. That is correct. And you will have to send us a copy of his primary insurance company's explanation of benefits along with the claim or review.
[CUSTOMER][NEUTRAL] Yes, mhm. OK, thank you. And previously we submitted multiple times, uh, through your electronic payer ID, but still you didn't receive the, uh, the claim on file. So what is the reason and do any exact, uh, rejection reason on this claim?
[AGENT][NEGATIVE] You could have had some type of technical error on your end.
[AGENT][NEUTRAL] The claims may also be faxed to our secure fax line because again, um you will have to provide us with the primary EOB along with your claim.
[CUSTOMER][NEUTRAL] OK, so we have to submit the claim to your fax only and you do have any mailing address for the claim?
[AGENT][NEUTRAL] No, sir, I didn't say only. No. Yeah, but [PII], I didn't say only facts.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] It can be faxed, it can be mailed, and it can be electronically submitted. But if you are having difficulty electronically submitting it, then we have the two other options available. The claim's mailing address is [PII]. The zip code is [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. So,
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And the fax number is [PII].
[CUSTOMER][NEUTRAL] OK. Let me reconfirm the mailing address. That is [PII]. This would be the address I'm having.
[AGENT][NEUTRAL] The zip code is [PII].
[AGENT][NEUTRAL] [PII]. Mhm.
[CUSTOMER][NEUTRAL] OK, [PII].
[CUSTOMER][POSITIVE] Oh, crazy. That's perfect.
[AGENT][NEUTRAL] And then once we have re yes and once we've received the claim and it's been processed, [PII], you should also be able to check our claim status by going to secured.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Mhm. OK, great. So thank you for the information. I really appreciate the information. I completed my all questions blank, and what would you call the customer for this call, [PII] may I know?
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] My name and today's date.
[CUSTOMER][POSITIVE] OK. So thanks for the information. Have a wonderful day and stay safe. Bye-bye. Take care.
[AGENT][POSITIVE] OK. Well, I hope you have a nice afternoon as well, and that's all I can help you with, [PII]. Thank you for calling APL.
[CUSTOMER][NEUTRAL] Bye bye.
[AGENT][NEUTRAL] Bye-bye.
[CUSTOMER][POSITIVE] OK great.