AccountId: 011433970860
ContactId: 165fee13-35c3-46f2-b031-0b72ec17416b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 235320 ms
Total Talk Time (AGENT): 106100 ms
Total Talk Time (CUSTOMER): 70345 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/13/165fee13-35c3-46f2-b031-0b72ec17416b_20250513T18:20_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, I'm calling from a provider's office uh for one of your members, and I wanted to review the process of how to submit claims on their behalf.
[AGENT][NEUTRAL] OK, let's take a look at the policy. Do you have their policy number?
[CUSTOMER][NEUTRAL] Yes, it's 0214465 M for Mike L for lion 8.
[AGENT][NEUTRAL] OK, let me pull this up here.
[AGENT][NEUTRAL] I think I missed a number. I'm sorry. 0214465.
[CUSTOMER][NEUTRAL] Oh, it's 26 665.
[AGENT][POSITIVE] Oh, sorry about that.
[AGENT][NEUTRAL] And then if I could get patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] Alright
[AGENT][NEUTRAL] So the active policy number is actually a different number. Would you like to copy that down?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So her active policy number is 02.
[CUSTOMER][NEUTRAL] What is it?
[AGENT][NEUTRAL] 45.
[AGENT][NEUTRAL] 1593.
[AGENT][NEUTRAL] Effective date on this is [PII].
[CUSTOMER][NEUTRAL] Can I repeat that to you just to make sure I got it right.
[AGENT][NEUTRAL] And
[AGENT][POSITIVE] Yeah, absolutely.
[CUSTOMER][NEUTRAL] 02451593
[AGENT][POSITIVE] Mhm, correct, yep.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And this is a secondary policy, so it covers deductible, co-pay, co-insurance. The primary does not. We accept claims electronically, via mail or fax, and I can give you any of that info or all.
[CUSTOMER][NEUTRAL] Yes, um.
[CUSTOMER][NEUTRAL] I'll take both.
[AGENT][NEUTRAL] OK. Uh, so the payer ID is 60801.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Claims mailing address is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And that is in [PII].
[AGENT][NEUTRAL] And the zip code is going to be [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Fax number is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] 942 3.
[CUSTOMER][NEUTRAL] OK, and do I just send the 15, do I send the 1500 form and the remittance from the primary or what all do you need?
[AGENT][NEUTRAL] Mm mhm yep, exactly, and then we just need the most important thing is the remittance from the primary so we know what they covered and what's remaining.
[CUSTOMER][NEUTRAL] OK, do you need the 1500 form then at all or just the remittance? OK.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes, submit that as well, uh huh.
[CUSTOMER][NEUTRAL] OK, so you don't need office visit notes or anything like that?
[AGENT][NEUTRAL] No, not necessary.
[CUSTOMER][NEUTRAL] OK, um.
[CUSTOMER][NEUTRAL] Alrighty well I will get them sent over then and then are the payments still submitted via check by mail?
[AGENT][NEUTRAL] Mhm, yep, they are.
[CUSTOMER][POSITIVE] OK thank you I appreciate your help.
[AGENT][POSITIVE] You, you're welcome. Have a good day.
[CUSTOMER][NEUTRAL] Bye.
[AGENT][NEUTRAL] Bye.