AccountId: 011433970860
ContactId: 1e4cd652-2ba4-4183-a9af-010cfb0551f7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1048180 ms
Total Talk Time (AGENT): 183354 ms
Total Talk Time (CUSTOMER): 238675 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=-0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/17/1e4cd652-2ba4-4183-a9af-010cfb0551f7_20250417T20:31_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII] calling from provider office. I'm looking for the claim status.
[AGENT][POSITIVE] Thank you, and I'll be more than happy to help you with the claim status. [PII], may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes, the number is uh.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you for that. And how many claims do you have in total today?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] How many claims do you have in total today?
[CUSTOMER][NEUTRAL] 3 clams.
[AGENT][NEUTRAL] OK, may I have the member's the first member's policy number?
[CUSTOMER][NEUTRAL] It's 02474464.
[AGENT][NEUTRAL] 02474464.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] My date of birth is [PII].
[CUSTOMER][NEUTRAL] And the name is uh [PII].
[CUSTOMER][NEUTRAL] Get married.
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And may I have the date of service and the total bill for the claim you like me to check on?
[CUSTOMER][NEUTRAL] The date of service is [PII] and the total bill amount is uh $3,824 even.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And it's $3,824.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] From [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] And is it alright if I place you on a brief hold?
[CUSTOMER][NEUTRAL] Hm.
[AGENT][NEUTRAL] May I place you on a brief hold? There's a few claims for this date, so I'm gonna look through them to see which one is yours.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Hello, [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Thank you so much for holding. I apologize for that wait. Is there any other total bill that can be for for this data service? Because we've received 4 claims, I'm sorry, 12345 claims, but none of them have the total bill that you gave.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] You get
[CUSTOMER][NEUTRAL] The date of services the
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] Is there any other total bill that the claim can be for?
[CUSTOMER][NEUTRAL] Mm just a moment to check.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Just a moment, please.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, can I, can you check, uh, for the claim number? I gave you the claim number.
[AGENT][NEUTRAL] Sure, what claim number do you have?
[CUSTOMER][NEUTRAL] Mm, it's E as in Echo, Y as in Yankee.
[CUSTOMER][NEUTRAL] 21377413.
[CUSTOMER][NEUTRAL] 0072325729.
[AGENT][NEUTRAL] OK, let me check. Do you mind if I place you on just a brief hold?
[CUSTOMER][NEUTRAL] OK. You are on hold.
[AGENT][NEUTRAL] OK, so that is not um an APL policy number, Ali, um, maybe it was filed with the primary insurance, but it was not filed with APL.
[AGENT][NEUTRAL] Hello [PII].
[CUSTOMER][NEUTRAL] Yes, I'm here. The total bill amount is $30,824.
[AGENT][NEUTRAL] I understand what you're saying. There's no claim here with APL. The policy, the claim number that you provided is not an APL policy number. So did you all file it with primary insurance because it has not been filed with the secondary insurance.
[CUSTOMER][NEUTRAL] Mm, yes, it's primary claim number.
[CUSTOMER][NEUTRAL] Mm, it's uh.
[CUSTOMER][NEUTRAL] Can you check with any other information?
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] When I search with the data service, any claim that came in on that date would populate. We have not received the claim with your total bill for the date of [PII].
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] That's my, uh, the claim is not billed bill to secondary.
[CUSTOMER][NEGATIVE] You will not receive this claim still.
[CUSTOMER][NEUTRAL] But the second is uh
[CUSTOMER][NEUTRAL] As a whole modify should be added to the procedure code 3536561. Please review the procedure coding on the claims its secondary hold.
[AGENT][NEUTRAL] Did you have any other claims that you wanted to go over today?
[CUSTOMER][NEUTRAL] OK. I check another plan.
[CUSTOMER][NEUTRAL] Just a moment, I pull up the claim. That's it to you.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Hello, [PII].
[CUSTOMER][NEUTRAL] Yes, the, yes, yes, member ID or NPI you required first.
[AGENT][NEUTRAL] Member ID?
[CUSTOMER][NEUTRAL] OK. Your member ID is 02474464. M as in Mike, L as in Lima, number 8.
[AGENT][NEUTRAL] All right, so that's the same patient. Is it a different data service?
[CUSTOMER][NEUTRAL] Mm just a moment.
[CUSTOMER][NEUTRAL] 972.
[CUSTOMER][NEUTRAL] 172.
[CUSTOMER][NEUTRAL] 17
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Just a moment to check.
[CUSTOMER][NEUTRAL] 9:29.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yes, it's uh the same number.
[CUSTOMER][NEUTRAL] That is, uh, the total amount is, uh,
[CUSTOMER][NEUTRAL] The same.
[CUSTOMER][NEUTRAL] $3,824.
[CUSTOMER][NEUTRAL] Like
[CUSTOMER][NEUTRAL] 3 claims on it.
[AGENT][NEUTRAL] It's so it's the same data service and the same total bills?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Hello
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, well, there's no claim on file, but we don't have a timely filing. So, um, you can file the claim if you like to. The policy was effective on the date of service. It's been effective since [PII], so you can still file the claim if you'd like. Did you need our fax number or mailing address or payer ID?
[CUSTOMER][NEUTRAL] Mm yeah the payer ID is uh.
[CUSTOMER][NEUTRAL] Pay tax ID is [PII].
[AGENT][NEUTRAL] Mm mm.
[AGENT][NEUTRAL] I'm [PII]ng if you need our payer ID to file the claim electronically.
[CUSTOMER][NEUTRAL] Mm, yes. I give me.
[AGENT][NEUTRAL] Our pay ID is 60801.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] We also have a mailing address and a fax number if you'd like. Would you like either of those?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] So I.
[AGENT][NEUTRAL] The fax number is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] And that's attention, APL claims department.
[CUSTOMER][NEUTRAL] No, I was
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK. It's not on file.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] All right. Was there anything else I can assist you with today, Ali?
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEGATIVE] Mm, no, it's 3 game but it's not fine as well.
[CUSTOMER][NEUTRAL] So what what just happened with these two claims.
[CUSTOMER][NEUTRAL] Just a moment.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Just a moment.
[CUSTOMER][NEUTRAL] Just a moment, hold.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, can you check the total charge amount of the 2 is.
[CUSTOMER][NEUTRAL] 80.95, 80.95.
[CUSTOMER][NEUTRAL] $80.95.
[AGENT][NEUTRAL] Yeah.