AccountId: 011433970860
ContactId: 1392b973-9fb2-4e5d-aa29-32b3a4637da8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 407940 ms
Total Talk Time (AGENT): 99046 ms
Total Talk Time (CUSTOMER): 95581 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=-0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/04/1392b973-9fb2-4e5d-aa29-32b3a4637da8_20250304T18:17_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Uh, hi, my name is [PII], last initial [PII] calling from provider office looking for claim status.
[AGENT][NEUTRAL] OK, I can help you with claim status, [PII]. Can I please get your callback number?
[CUSTOMER][NEUTRAL] [PII] direct line or extension.
[AGENT][NEUTRAL] Thank you. And then um may I get the patient's name, date of birth, and policy number please?
[CUSTOMER][NEUTRAL] Uh sorry, what do you need?
[AGENT][NEUTRAL] The patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] First, uh, the policy number I have, it's 02.
[CUSTOMER][NEUTRAL] 451-262.
[CUSTOMER][NEUTRAL] Patient name [PII].
[CUSTOMER][NEUTRAL] [PII] date of birth [PII].
[AGENT][NEUTRAL] OK, let me look that up real quick.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and then may I have um the date of service and the charge amount claim.
[CUSTOMER][NEUTRAL] OK, OK, uh, I have a date range. It is [PII].
[CUSTOMER][NEUTRAL] The amount of $1050 even.
[AGENT][NEUTRAL] OK, and then what is the name facility you're calling from?
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] The name of the facility you're calling from?
[CUSTOMER][NEUTRAL] OK, it's Pro Health partner of Medical Group INC billing provider named [PII].
[AGENT][NEUTRAL] I'm gonna put you on a brief hold while I look up the time for you and I'll be right back.
[CUSTOMER][POSITIVE] OK, take your time.
[AGENT][POSITIVE] Thank you, sir.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Oh thank you for holding for me, [PII]. So looking on data service of [PII], I do not find a claim on file for the amount that you have given.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, OK. So, and, uh, could you please verify your mailing address, claim mailing address?
[AGENT][NEUTRAL] Yes sir, it's [PII].
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] And that is in [PII].
[AGENT][NEUTRAL] And the zip code is [PII].
[CUSTOMER][NEUTRAL] OK, thank you, and patient is active on the data of service. Could you please provide me the policy effective and dumb that.
[AGENT][NEUTRAL] Uh, the effective date is [PII] and the policy terminated on [PII].
[CUSTOMER][NEUTRAL] OK, and you are the primary insurance for this patient?
[AGENT][NEUTRAL] This is a um limited hospital indemnity plan and we're not the primary. We're not the major medical.
[CUSTOMER][NEUTRAL] So,
[CUSTOMER][NEUTRAL] So who is the primary for this patient?
[AGENT][NEUTRAL] I don't have that information.
[CUSTOMER][NEUTRAL] What is the uh timely falling limit to submit the claim?
[AGENT][NEUTRAL] We don't have one.
[CUSTOMER][NEUTRAL] Sorry.
[AGENT][NEUTRAL] There is not one.
[CUSTOMER][NEUTRAL] Actually, I need the timely falling limit.
[AGENT][NEGATIVE] There is no timely filing limit.
[CUSTOMER][NEUTRAL] OK, thank you. Please generate the call reference number.
[AGENT][NEUTRAL] Yes sir
[AGENT][NEUTRAL] The name [PII] and today's date.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] Thank you, [PII]. Have a wonderful day. Bye-bye.
[AGENT][POSITIVE] Thank you for calling APL. You have a great day also. bye bye sir.