AccountId: 011433970860
ContactId: 1f67d304-35c8-43fe-b783-6d41332dc229
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1073719 ms
Total Talk Time (AGENT): 188287 ms
Total Talk Time (CUSTOMER): 406851 ms
Interruptions: 9
Overall Sentiment: AGENT=1.1, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/03/1f67d304-35c8-43fe-b783-6d41332dc229_20250603T14:27_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. This is [PII] calling from Envision Health. Could you please help me with the claim status?
[AGENT][NEUTRAL] Yes, yes, [PII], I can help you with claim status, sir. Can I please get your callback number?
[CUSTOMER][NEUTRAL] OK sir.
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] [PII] and the extension will be [PII].
[AGENT][NEUTRAL] Thank you, sir. And then what is the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Patient's name is.
[CUSTOMER][NEUTRAL] Patient's name is [PII].
[CUSTOMER][NEGATIVE] I know she's not working because she's using.
[AGENT][NEUTRAL] OK, and then what's [PII]'s date of birth?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] OK. And his policy number, please?
[CUSTOMER][NEUTRAL] Policy number.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] 02286214.
[CUSTOMER][NEUTRAL] making
[AGENT][NEUTRAL] OK, let me pull that up real quick.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Right
[AGENT][NEUTRAL] Alright and then may I get [PII]'s date of service and charge amount?
[CUSTOMER][NEUTRAL] So.
[CUSTOMER][NEUTRAL] Data service is
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And then what are the charges after the primary insurance paid their part?
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] OK, let me check.
[AGENT][NEUTRAL] Yes sir.
[CUSTOMER][NEUTRAL] Just give me a second.
[AGENT][POSITIVE] Yes sir, take your time.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Just give me a second.
[CUSTOMER][NEUTRAL] I have a
[CUSTOMER][NEUTRAL] Hello.
[AGENT][POSITIVE] Yes, sir. Yes, sir. I'm here. I'm waiting for you.
[CUSTOMER][NEUTRAL] OK. I thought you have cut the call. Sorry.
[AGENT][NEUTRAL] You're fine.
[AGENT][NEUTRAL] Yes, sir. No, sir. I'm still here.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] No
[CUSTOMER][NEUTRAL] By the way, your name?
[AGENT][NEUTRAL] My name is [PII]
[CUSTOMER][NEUTRAL] OK. And uh
[CUSTOMER][NEUTRAL] It's uh 655.53. It's the leftover balance from the primary.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and then what was the original charge amount before the 65553?
[CUSTOMER][NEUTRAL] Uh, the original charge amount is
[CUSTOMER][NEUTRAL] It's 3,196.00.
[AGENT][NEUTRAL] OK, alright, [PII], I'm gonna put you on a quick hold while I look up this claim for us and I'll be right back sir.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK. You are on hold.
[AGENT][POSITIVE] Thank you, sir.
[AGENT][NEUTRAL] [PII], can you give me the name of the facility you're calling from?
[CUSTOMER][NEUTRAL] Envision health.
[CUSTOMER][NEUTRAL] And.
[AGENT][POSITIVE] OK, thank you, sir. It's gonna be a quick hold again.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Thank you [PII] for holding for me. So looking on data service of [PII] for [PII], I do not find a claim on file.
[CUSTOMER][NEUTRAL] Uh, like we got payments, right? How can, uh, there is no claim on file? Could you please check once again?
[AGENT][NEUTRAL] What is the um
[AGENT][NEUTRAL] Yes, sir. What is the claim number that you got the payment for?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It's 2024.
[CUSTOMER][NEUTRAL] 090
[CUSTOMER][NEUTRAL] 563 3.
[CUSTOMER][NEUTRAL] 6282.
[AGENT][NEUTRAL] OK, that is not our claim number that's not APL.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Like we are not, I'm saying that.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] I'm sorry, uh, this is not your claim. Actually, uh, is, uh, this, uh, patient is eligible for APO?
[AGENT][NEUTRAL] Uh, yes, he does have, uh.
[AGENT][NEUTRAL] An active policy. The effective date of the policy is [PII].
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Uh, from [PII] and uh it's still active.
[AGENT][NEUTRAL] Of [PII].
[AGENT][NEUTRAL] And it is current.
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Uh, what is the, uh, termination date?
[AGENT][NEUTRAL] There is not one, it's current and active.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Like, uh, there is a timely filing limit, uh, to send the claim.
[AGENT][NEGATIVE] No sir, there's no timely filing limit.
[CUSTOMER][NEUTRAL] OK. Just give me a second.
[AGENT][NEUTRAL] Yes sir.
[CUSTOMER][NEUTRAL] Uh, uh, can you give me, uh, payer ID to, uh, bill this claim?
[AGENT][NEUTRAL] Yes, sir. It's 60801.
[CUSTOMER][NEUTRAL] 60801
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] Uh, there is no claim on file, right?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] Very
[CUSTOMER][NEUTRAL] OK. And uh
[CUSTOMER][NEUTRAL] May I get the mailing address, please?
[AGENT][NEUTRAL] Yes, that will be APL claims and it's [PII].
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] That's in [PII] City, Oklahoma.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] And the zip code is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Could you please say the zip code again?
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yes, [PII].
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][POSITIVE] Thank you so much.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] And there is a time limit uh to send a claim.
[AGENT][NEGATIVE] No, there's no timely filing limit.
[CUSTOMER][POSITIVE] OK, thank you so much, dear. By the way, your name? [PII], uh, [PII], I have other claim. If you don't mind, can we go with that?
[AGENT][NEUTRAL] My name is [PII]
[AGENT][NEUTRAL] Yes, what's the member's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, dear. Just give me a second. Let me check that.
[AGENT][NEUTRAL] Yes.
[AGENT][POSITIVE] Yes, take your time.
[CUSTOMER][POSITIVE] Thank you so much, dear.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Oh my.
[CUSTOMER][NEUTRAL] Sorry, sir. Just give me a second.
[AGENT][POSITIVE] Yes sir, take your time.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Can you
[CUSTOMER][NEUTRAL] OK. Just give me a second.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I mean.
[CUSTOMER][NEUTRAL] The one
[CUSTOMER][POSITIVE] I love like to take a busy break.
[CUSTOMER][NEUTRAL] [PII], how was your day going on [PII]?
[AGENT][POSITIVE] It's going good so far. How is your day going?
[CUSTOMER][POSITIVE] Yes, little bit good.
[AGENT][POSITIVE] Awesome.
[CUSTOMER][NEUTRAL] No, I they got married.
[CUSTOMER][NEUTRAL] Should I say the member ID? OK. And uh
[AGENT][NEUTRAL] Yes, please.
[CUSTOMER][NEUTRAL] 1 2nd, 1 2nd. I'm sorry, it is.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Other number I ideas I thought.
[AGENT][NEUTRAL] OK, that's fine.
[CUSTOMER][NEUTRAL] Start 81.
[CUSTOMER][NEUTRAL] You didn't.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] You.
[CUSTOMER][NEUTRAL] OK, the member ID is 950.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 453-319-1.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, that looks like a different.
[AGENT][NEUTRAL] Uh, that's not one of our policy numbers for APL.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I'm sorry, just give me a second, dear.
[AGENT][POSITIVE] Yes, go ahead and take your time.
[CUSTOMER][NEUTRAL] Really
[CUSTOMER][NEUTRAL] OK, I'm sorry, dear. Uh, I don't have any other game. I thought it was an APO plan, but it is not, uh,
[AGENT][NEUTRAL] OK. That's fine. Yes.
[CUSTOMER][POSITIVE] Thank you so much for your assistance.
[AGENT][POSITIVE] You're very welcome, sir. Thank you for calling APL [PII]. I hope you have a good day.
[CUSTOMER][POSITIVE] I hope you have a good day. Enjoy your day.
[AGENT][POSITIVE] Thank you. Thank you very much. Bye-bye, sir.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Bye-bye.