AccountId: 011433970860
ContactId: 1e6e5d42-8425-45e9-95b7-23da49510724
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 261820 ms
Total Talk Time (AGENT): 71239 ms
Total Talk Time (CUSTOMER): 163359 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/16/1e6e5d42-8425-45e9-95b7-23da49510724_20250516T20:52_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, uh, my name is [PII], and I'm calling from a provider's office to inquire about, um, about checking claim status for one of our patients.
[AGENT][NEUTRAL] Alright, I'm happy to check on a claim. What's the patient policy number?
[CUSTOMER][NEUTRAL] Yeah, it is 02519419.
[AGENT][NEUTRAL] All right, thank you for that. And then patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yeah, [PII] spelled [PII] Last name is [PII] spelled [PII].
[AGENT][NEUTRAL] Thank you. And date of birth?
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] OK, and then what was the date of service?
[CUSTOMER][NEUTRAL] Yeah, it's uh [PII].
[AGENT][NEUTRAL] Not showing any claims on file for this patient actually.
[CUSTOMER][NEUTRAL] Yeah, um, so I believe it was sent over, um, this actually before I begin, um, this should be the patient's secondary insurance, and, um, we received, OK, perfect, and then we received the payment from their primary Cigna insurance, and then we actually just sent it over um to APL um on uh [PII] and
[AGENT][POSITIVE] Mhm, correct.
[CUSTOMER][NEGATIVE] We sent it through a clearing house and we got a notification saying that um they will mail like a physical claim to you guys since electronically it was not possible I think.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, and I was just wondering if uh you guys got that at all. It seems like you haven't, um, from the looks of it.
[AGENT][NEUTRAL] Yeah doesn't look like we have anything on file as of yet.
[CUSTOMER][NEUTRAL] OK, um, and in that case, should I just mail a physical claim myself, do you think? um.
[AGENT][NEUTRAL] Yeah, or you guys or you guys can fax it. I can give you the fax number if that works for you.
[CUSTOMER][POSITIVE] Oh, that, yeah, that will be much, much better. Give me one sec please.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, and the fax number is.
[AGENT][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 942 [PII].
[CUSTOMER][NEUTRAL] OK, so that's [PII]. Is that right?
[AGENT][POSITIVE] Mhm, yep, that is correct.
[CUSTOMER][NEUTRAL] OK. Awesome. All right. Um, let me see. And then, um, I, when I send the claim out, I'm gonna attach a 1500 claim form with the medical records as well as the, um, uh, explanation of benefits from the primary insurance, but should I attach anything else?
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Nope, that'll be perfect.
[CUSTOMER][NEUTRAL] OK perfect and then um uh do I need like a cover sheet uh of the fax?
[AGENT][NEUTRAL] You can do a cover if you want, um, and mark attention to claims on it also.
[CUSTOMER][NEUTRAL] Of any sort?
[CUSTOMER][NEUTRAL] OK, got you, but it's not required?
[AGENT][NEUTRAL] No, not required.
[CUSTOMER][NEUTRAL] OK, perfect, um, and let me see here and then, um, do you guys have like a timely filing? We, uh, actually just received this insurance on hand, um, and just one was wondering if it was like as long as it was like billed to like the primary, you guys will take it, uh, anything along the lines of timely finance if you can just provide that.
[AGENT][NEUTRAL] Yeah absolutely so yeah we don't have any sort of timely filing limit.
[CUSTOMER][POSITIVE] Awesome. Perfect. Thanks so much. Um, well, in that case, I will fax these over, um, and yeah, I really appreciate your help, but um, can I just get a uh reference number for this, uh, exchange here for today?
[AGENT][POSITIVE] All right, sounds good.
[AGENT][POSITIVE] Yeah, absolutely.
[AGENT][NEUTRAL] Call reference is my name with my last initial in today's date. My name again is [PII], that's [PII] Last initial is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Awesome. Well, thank you so much for your help, sir. I really appreciate it.
[AGENT][POSITIVE] You're welcome. Have a great day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye bye.