AccountId: 011433970860
ContactId: 1afbcab1-18c0-4302-a2e6-dd8fdb79e375
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 372769 ms
Total Talk Time (AGENT): 113861 ms
Total Talk Time (CUSTOMER): 148454 ms
Interruptions: 3
Overall Sentiment: AGENT=-0.1, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/19/1afbcab1-18c0-4302-a2e6-dd8fdb79e375_20250619T16:45_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah, this is [PII] calling from provider site for claim status.
[AGENT][NEUTRAL] Uh, I'm sorry, you said we were checking eligibility?
[CUSTOMER][NEUTRAL] Yeah, eligibility claim status.
[AGENT][NEUTRAL] OK so we're checking on a claim.
[CUSTOMER][NEUTRAL] Yeah, medical claim, general.
[AGENT][NEUTRAL] OK, I can check on that claim for you. Uh, [PII], can I get a good callback number from you first in case we're disconnected please?
[CUSTOMER][NEUTRAL] Yes, [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And do you have that policy number?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Just a second. Policy number is 83523.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Could you repeat that? I'm sorry.
[CUSTOMER][NEUTRAL] 83523
[AGENT][NEUTRAL] OK, that's gonna be a bit too short to be one of our policy numbers. You maybe have their social I could search for them that way.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, Social security number is [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK thank you one moment.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] And then what was the name for the member?
[CUSTOMER][NEUTRAL] First name is [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Date of birth [PII].
[AGENT][NEUTRAL] OK thank you one moment.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] The
[CUSTOMER][NEUTRAL] Hi
[AGENT][NEUTRAL] OK, so this number has uh a cancer policy with us is that what we're looking at?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] No, maybe.
[CUSTOMER][NEUTRAL] No, just a second. I will check. Just a second.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, maybe this is because we have code of ECG and EKG code.
[AGENT][NEUTRAL] That's OK OK so um just so that I understand, are we we're checking on a claim that was submitted to us?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, what was that date of service, please?
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] And then what was that bill amount please?
[CUSTOMER][NEUTRAL] Bill amount, total bill amount is $54.
[CUSTOMER][NEUTRAL] you
[AGENT][NEUTRAL] 54
[CUSTOMER][NEUTRAL] Yeah, 54.
[CUSTOMER][NEUTRAL] The
[AGENT][NEUTRAL] What was the tax ID for this provider, please?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, tax ID 27.
[CUSTOMER][NEUTRAL] 40266
[CUSTOMER][NEUTRAL] 58.
[AGENT][NEUTRAL] OK thank you one moment.
[CUSTOMER][NEUTRAL] 472.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Was this for procedure code is it 93,000?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] We
[AGENT][NEUTRAL] OK, so we did receive this claim, however, we were unable to pay a benefit, uh, the policy does not provide benefits for office visits or the treatment, uh.
[AGENT][NEUTRAL] That was under the this claim.
[CUSTOMER][NEUTRAL] OK, so your claim did not receive any claim regarding the data service?
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] We did receive it, um.
[CUSTOMER][NEUTRAL] OK. So,
[CUSTOMER][NEUTRAL] OK. OK. I receive it. May I know when, may I know when?
[AGENT][NEUTRAL] I'm sorry.
[AGENT][POSITIVE] Oh no wait oh hold on actually I'm so sorry one moment.
[AGENT][NEUTRAL] This was just for
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I was looking at a different date. I apologize.
[AGENT][NEUTRAL] OK, so we've not received a claim for that date of service from.
[AGENT][NEUTRAL] This provider except for one that was for $241.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, no issue. Can you provide me your mailing address where we can submit claim?
[AGENT][NEUTRAL] Yes, that is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And that is in [PII]?
[AGENT][NEUTRAL] Zip code is [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. ZIP code is [PII], correct?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK. May I know time file limit of claim?
[AGENT][NEGATIVE] There is no timely filing limit.
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEGATIVE] There is no timely filing limit.
[CUSTOMER][NEUTRAL] on
[CUSTOMER][POSITIVE] OK, no issue. Thank you for this claim. This claim is done from my end. I have one more number, different member.
[AGENT][NEUTRAL] OK, we're looking at a claim for a different member?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] 005.
[AGENT][NEUTRAL] OK, one moment.