AccountId: 011433970860
ContactId: 1276f846-ed48-40c9-83fd-b146714fdc23
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 751520 ms
Total Talk Time (AGENT): 279923 ms
Total Talk Time (CUSTOMER): 186512 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/27/1276f846-ed48-40c9-83fd-b146714fdc23_20250127T17:51_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] Yeah, hi. My name is [PII]. I'm calling from provider office. Today I'm checking the claim status. Can you please help me the claim status?
[AGENT][NEUTRAL] You're needing claim status, is that correct?
[CUSTOMER][NEUTRAL] Yes. Yes.
[AGENT][POSITIVE] Yes ma'am, I can help you with that and could you please spell your name for me?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII]. OK, thank you. And [PII], what is your callback number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And no extensions?
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] OK, thank you. And [PII] how many claims do you have to check status on?
[CUSTOMER][NEUTRAL] I have 22 claims.
[AGENT][NEUTRAL] Are they for the same patient or two different patients? Same patient and two dates of service?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Same patient.
[CUSTOMER][NEUTRAL] Yeah, 2 data services I have.
[AGENT][NEUTRAL] Mhm, yes ma'am, I can help you. And [PII], what is the policy number?
[CUSTOMER][NEUTRAL] Policy number would be 02479217.
[AGENT][POSITIVE] Thank you one moment.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And [PII], any information that I do provide for you today will be a verification of benefits and not a guarantee of payment. You will use my name along with today's date if you need a call reference number, and then if we have these claims on file, Jersey, and you need a copy of these explanation of benefits, you may obtain those by going to our portal and printing them, and our portal website is secured.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And what is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] 1 2nd.
[CUSTOMER][NEUTRAL] One second.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Yeah, patient name would be first name.
[CUSTOMER][NEUTRAL] [PII], and last name would be [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm. Date of birth?
[CUSTOMER][NEUTRAL] Date of birth would be [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And what is the first date of service and total bill amount?
[CUSTOMER][NEUTRAL] The data service would be?
[CUSTOMER][NEUTRAL] [PII] and charge amount would be $442.
[AGENT][POSITIVE] Thank you one moment.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, so this claim was received on [PII]. It was processed on [PII].
[AGENT][NEUTRAL] The claim number is 354.
[AGENT][NEUTRAL] 908.
[CUSTOMER][NEUTRAL] One second. Can you please repeat?
[CUSTOMER][NEUTRAL] Can you please repeat one second the claim number?
[AGENT][NEUTRAL] 3,549,080
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] There was a benefit paid in the amount of $129.03.
[AGENT][NEUTRAL] On single check.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 202.
[AGENT][NEUTRAL] 1967.
[CUSTOMER][NEUTRAL] 1 2nd.
[CUSTOMER][NEUTRAL] Yeah, can you please tell me the check number?
[AGENT][NEUTRAL] 2021967.
[CUSTOMER][NEUTRAL] 1967, 2021967. It's correct?
[AGENT][POSITIVE] 6, that is, that is correct.
[CUSTOMER][NEUTRAL] Can you please provide me the check issue date?
[AGENT][NEUTRAL] The same date as the process date that I gave you?
[CUSTOMER][NEUTRAL] Yeah. OK. Can you please provide me a check clear date?
[AGENT][NEUTRAL] It has not cleared as of now?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Clear date, not it clear that the claim was paid recently, right?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][POSITIVE] OK. Thank you so much. And I have uh another dog.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK. And what is your next date of service?
[CUSTOMER][NEUTRAL] Yeah, one second. The unex data service would be [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm. Total
[CUSTOMER][NEUTRAL] Uh, the bill amount would be $442.
[AGENT][NEUTRAL] Build a male.
[CUSTOMER][NEUTRAL] $442.
[AGENT][NEUTRAL] Jersey.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] The same amount for 42?
[CUSTOMER][NEUTRAL] Yeah, $442.
[AGENT][POSITIVE] Thank you. One moment.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Oh my [PII].
[AGENT][NEUTRAL] So this claim was also received. It was received on [PII].
[AGENT][NEUTRAL] Processed on [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The claim number is 354.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 9069.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The benefit paid was 129 dollars.03 cents.
[AGENT][NEUTRAL] That was on single check 202.
[AGENT][NEUTRAL] 1965.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, and I have one more last, uh, data service, same patient.
[AGENT][NEUTRAL] Oh you
[AGENT][NEUTRAL] Oh, I'm sorry, you had said you had 2, so give me just a moment.
[CUSTOMER][NEUTRAL] Yeah. I'm so sorry. Actually, I didn't see that the doors. That's the reason I'm telling to only. Now, I just saw the date of service. I'm sorry.
[AGENT][NEUTRAL] That's OK.
[AGENT][POSITIVE] Yeah, no, no worries.
[AGENT][POSITIVE] That's OK, no worries. Just one moment.
[CUSTOMER][POSITIVE] Yeah, thank you, buddy.
[AGENT][NEUTRAL] OK, and the next date of service and total bill amount and it is for the same patient, correct?
[CUSTOMER][NEUTRAL] 11
[CUSTOMER][NEUTRAL] Yeah, same patient.
[AGENT][NEUTRAL] OK. Mhm. [PII].
[CUSTOMER][NEUTRAL] [PII], [PII] and charge amount would be $275.
[AGENT][POSITIVE] Thank you, one moment.
[AGENT][NEUTRAL] OK, we do not have a claim on file for 11-27-2024.
[CUSTOMER][NEUTRAL] OK, it's a claim not on file. OK.
[AGENT][POSITIVE] That is correct, yes, ma'am.
[AGENT][NEUTRAL] Now, we will have to have a copy of the primary insurance company's explanation of benefits along with the claim for review.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, sure.
[CUSTOMER][NEUTRAL] Yeah. Can you please provide me the effective date and time, effective date and the term date?
[AGENT][NEUTRAL] If there is no term date, the policy is active. The effective date is [PII].
[CUSTOMER][NEUTRAL] Yeah. Yeah.
[CUSTOMER][NEUTRAL] OK. [PII].
[CUSTOMER][NEUTRAL] Can you please tell me the pay ID?
[AGENT][NEUTRAL] 60801.
[CUSTOMER][NEUTRAL] OK. Can you please provide me the mailing address?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The zip code is [PII].
[CUSTOMER][NEUTRAL] Spelling, can you please, can you please tell me the spelling?
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] The next word is [PII]
[AGENT][NEUTRAL] The state is [PII].
[CUSTOMER][NEUTRAL] City
[AGENT][NEUTRAL] The city has two words. The city name is two words, [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The state is [PII].
[AGENT][NEUTRAL] And the zip code is [PII].
[CUSTOMER][NEUTRAL] 1 2nd.
[CUSTOMER][NEUTRAL] ZIP code?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Can you please provide me the timely filing?
[AGENT][NEGATIVE] There is no timely filing?
[CUSTOMER][NEUTRAL] But I didn't understood.
[AGENT][NEGATIVE] There is no timely filing limit.
[CUSTOMER][NEUTRAL] OK. No time limit.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 1 2nd.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Can you please uh provide me the call reference number?
[AGENT][NEUTRAL] My name and today's date.
[CUSTOMER][NEUTRAL] Can you please spell your name?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And [PII]
[AGENT][NEUTRAL] Hello.
[AGENT][NEGATIVE] Pardon me.
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] I'm sorry, I did, I did not understand what you asked.
[CUSTOMER][NEUTRAL] Can you please tell me your last name?
[AGENT][NEUTRAL] The first initial to my last name is [PII], and [PII]?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] Yeah, thank you so much. Have a great day.
[AGENT][POSITIVE] Well, you're very welcome. So is that all I can help you with today, [PII]?
[CUSTOMER][POSITIVE] Yeah, I don't need anything. Thank you.
[AGENT][POSITIVE] OK, well, you're welcome and thank you again for calling APL. I hope you have a nice afternoon also.
[CUSTOMER][POSITIVE] Yeah, thank you, same to you.
[AGENT][POSITIVE] Oh, you're welcome.
[AGENT][NEUTRAL] Bye bye.