AccountId: 011433970860
ContactId: 13eb84fe-9563-462c-8b8b-0d316b625186
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 514900 ms
Total Talk Time (AGENT): 169000 ms
Total Talk Time (CUSTOMER): 105979 ms
Interruptions: 2
Overall Sentiment: AGENT=1.1, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/24/13eb84fe-9563-462c-8b8b-0d316b625186_20250124T14:07_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] Uh yes, hi [PII]. My first name is [PII]. My last name is [PII] calling you from the provider's office looking for claim status.
[AGENT][NEUTRAL] OK, [PII], you have one claim to check claim status on, is that correct?
[CUSTOMER][NEUTRAL] Uh, yes, I have, uh, 2 claims to take claim status.
[AGENT][NEUTRAL] Are they for the same member? Are they for the same patient or different patients?
[CUSTOMER][NEUTRAL] A different patient.
[AGENT][POSITIVE] Yeah, sure I can help you with that. And what is your callback number?
[CUSTOMER][NEUTRAL] Uh, yes, the callback number is [PII].
[AGENT][NEUTRAL] Thank you. And [PII], uh, you will use my name that I gave you along with today's date as your call reference number for both claims. Also, any information that I provide for you today on the claims will be a verification of benefits and not a guarantee of payment. And lastly, [PII], if we do have a claim on file and you need a copy of the explanation of benefits, you may obtain that by going to our portal. It's secured.
[CUSTOMER][NEUTRAL] Uh.
[AGENT][NEUTRAL] [PII] to print that out.
[AGENT][NEUTRAL] And what is your first patient's policy number, [PII]?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, yes, the patient's study is 02435035.
[AGENT][POSITIVE] Thank you. Give me a couple of moments to get all of the information pulled up.
[AGENT][NEUTRAL] OK. Um, and your patient's name, please, and their date of birth?
[CUSTOMER][NEUTRAL] The date of birth is [PII]. 1st name is [PII], last name is [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And the data service and total bill amount?
[CUSTOMER][NEUTRAL] [PII] total charge is $3,694 even.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] Just one moment
[AGENT][NEUTRAL] OK, and again, you said the total bill amount is $3,694 in data services 2172024?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. I do not have a claim on file for her for that data service and total bill amount.
[CUSTOMER][NEUTRAL] OK, can I have the members effective date?
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] The effective date is [PII] and it is still active.
[CUSTOMER][NEUTRAL] And uh what is the timely filing limit?
[AGENT][NEGATIVE] There is no timely filing limit?
[CUSTOMER][POSITIVE] OK, thank you, let's move to the next patient.
[AGENT][NEUTRAL] Yes. OK, just one moment please, for me to finish my note on this one.
[CUSTOMER][NEGATIVE] Gotcha.
[AGENT][NEUTRAL] And because this is a supplement to her primary insurance, [PII], when the claim is submitted to APL for review, we must also have a copy of her primary insurance company's explanation of benefits also.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and your next patient's policy number?
[CUSTOMER][NEUTRAL] 01739550.
[AGENT][POSITIVE] Thank you, one moment.
[AGENT][NEUTRAL] OK. And your patient's name and date of birth?
[CUSTOMER][NEUTRAL] OK, uh, so.
[CUSTOMER][NEUTRAL] The patient's first name is uh [PII]. Last name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And the uh excuse me, the data service and total bill amount.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] [PII], and the total charge is $860 even.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] OK, so I do not have a claim. You said the date of service again it's [PII].
[AGENT][NEUTRAL] To [PII].
[CUSTOMER][NEUTRAL] Mhm yes.
[AGENT][NEUTRAL] Is that correct? for 860? OK, so yes, so there is no claim on file on this policy for the data service. This policy was active from [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And it turned [PII], and there is no other coverage beyond that point with APL.
[CUSTOMER][NEUTRAL] So you're saying that uh active from [PII].
[AGENT][NEUTRAL] There's no policy active for that. Mhm.
[CUSTOMER][NEUTRAL] Uh huh, so you're saying that uh [PII] is the effective date and the term date is [PII].
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you so much. Yes, uh, that's all I need for today. Um, have a very blessed day. Thank you so much.
[AGENT][NEUTRAL] Yeah
[AGENT][POSITIVE] OK. Well, I hope you do too, [PII], and thank you again for calling APL and I hope you have a great weekend as well.
[CUSTOMER][POSITIVE] Thank you, thank you.
[AGENT][NEUTRAL] Uh-huh. Bye-bye.
[CUSTOMER][NEUTRAL] Right