AccountId: 011433970860
ContactId: 124e7ba3-37c7-4707-9d81-84ce126b57e0
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 273459 ms
Total Talk Time (AGENT): 110482 ms
Total Talk Time (CUSTOMER): 60001 ms
Interruptions: 0
Overall Sentiment: AGENT=0, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/12/124e7ba3-37c7-4707-9d81-84ce126b57e0_20250212T17:47_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from private office, and I'm looking for a payment status.
[AGENT][NEUTRAL] I'm sure, [PII]. I can assist you with claim status. Um, first, I'll need a good callback number just in case we're disconnected.
[CUSTOMER][NEUTRAL] Callback number is [PII].
[AGENT][NEUTRAL] OK, thank you. Now, I need the policy number, please.
[CUSTOMER][NEUTRAL] Yeah, it is 02144068.
[AGENT][NEUTRAL] And please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Patient name is [PII] and date of birth is [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, thank you. Um, now I need the date of service and bill charges on the claim.
[CUSTOMER][NEUTRAL] Yeah, data service is [PII].
[CUSTOMER][NEUTRAL] And total charge amount is $3100 even.
[AGENT][NEUTRAL] And I'm still waiting on my system. One moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK. Do you have a claim number?
[CUSTOMER][NEUTRAL] Sorry, I don't have because this is a fresh claim, so I just need to take a follow for that.
[AGENT][NEUTRAL] OK, because I'm not showing that claim on file, how was it submitted?
[CUSTOMER][NEUTRAL] It was submitted through mailing address.
[AGENT][NEUTRAL] OK. Yeah, I'm not showing it on file. Um, claims can be faxed in and we also have a pair ID. Do you need that information to resubmit the claim?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] But the date of service is correct, it's [PII].
[AGENT][NEUTRAL] Right, I'm not showing a claim on file with that date of service and those bill charges.
[CUSTOMER][NEUTRAL] And can you just verify the mailing address?
[AGENT][NEUTRAL] Um, yes, the mailing address is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And that's in [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] OK, and member was active on of service?
[AGENT][NEUTRAL] Um, let me get that information for you. One moment.
[AGENT][NEUTRAL] And just let me advise you that verification of coverage does not guarantee payment of claims. Um, the effective date on this policy was [PII], and the policy is still active, so yes, the member was active on the date of service.
[CUSTOMER][NEUTRAL] OK, and what is the timely filing the limit to send a credit, sorry, to send a fresh claim?
[AGENT][NEGATIVE] Um, there's no timely filing limit.
[CUSTOMER][NEUTRAL] OK, so please provide me the fax number and the pay ID.
[AGENT][NEUTRAL] The fax number is [PII].
[AGENT][NEUTRAL] [PII] and please attention it to the claims department.
[CUSTOMER][NEUTRAL] OK, and the pay ID?
[AGENT][NEUTRAL] The pay ID is 60801.
[CUSTOMER][POSITIVE] OK, thank you so much. I'm done. Can you please provide me call reference number?
[AGENT][NEUTRAL] Yes, for the reference number, you can use my name and today's date. My name is [PII]. It's spelled [PII] Last initial is [PII], and today's date. Is there anything else that I can assist you with?
[CUSTOMER][POSITIVE] No, I'm done thank you Say.
[AGENT][POSITIVE] OK. Well, I thank you, [PII], for calling APL. You have a great rest of your day. Mm bye.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Mm