AccountId: 011433970860
ContactId: 233263eb-32a7-4f05-b8dc-ff6246f02710
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 355200 ms
Total Talk Time (AGENT): 136375 ms
Total Talk Time (CUSTOMER): 112518 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/28/233263eb-32a7-4f05-b8dc-ff6246f02710_20250528T19:50_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yeah. Hi, [PII]. Uh, I'm [PII]. I'm calling from provider's office regarding our claims.
[AGENT][NEUTRAL] OK, and what you're needing claim status, is that correct?
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][POSITIVE] Yes, I can help you with that. And what is your callback number?
[CUSTOMER][NEUTRAL] [PII] with an extension of [PII].
[AGENT][NEUTRAL] Thank you. And now how many claims do you have to check status on?
[CUSTOMER][NEUTRAL] I do have 2 claims for the same number.
[CUSTOMER][NEUTRAL] Only for 11 member. I do have two claims. Mhm.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] OK, I can help you with those, and [PII], you will use my name that I gave you along with today's date as your call reference number.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] May I know the issue the last time to see.
[AGENT][NEUTRAL] S as in Sam, and yours?
[CUSTOMER][NEUTRAL] Yeah. OK.
[CUSTOMER][NEUTRAL] Uh, uh, P as in Peter.
[AGENT][NEUTRAL] Thank you. And also [PII], if we do have the claims on file once I provide you the claim numbers, you may print the explanation of benefits directly from our portal by going to [PII].
[CUSTOMER][POSITIVE] Sure, definitely.
[AGENT][NEUTRAL] If you need a copy of those, and then lastly, any information that is provided will be a verification of benefits and not a guarantee of payment. So what is your patient's policy number?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] The patient's policy number is going to be, it's uh 01848596 M as in Mike L as in Lima 8.
[AGENT][NEUTRAL] OK, thank you. One moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And what is your first date of service and total bill amount, please?
[CUSTOMER][NEUTRAL] The data services uh [PII] with the bill amount of $542 even.
[AGENT][NEUTRAL] OK, and if you could again please verify the insured's name and date of birth for me?
[CUSTOMER][NEUTRAL] My mother's first name is going to be [PII] and the last name is [PII] and the date of birth is going to be [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, thank you. Alright, so one moment please.
[AGENT][NEUTRAL] OK, and so you said the first data services for [PII] for $542 is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, so we do not have a claim on file for that data service.
[AGENT][NEUTRAL] For this member.
[CUSTOMER][NEUTRAL] OK, uh, may I know what is the payer ID to submit the claim?
[AGENT][NEUTRAL] 660801 and you will also need to include a copy of the primary insurance company's explanation of benefits as well.
[CUSTOMER][POSITIVE] Sure, I appreciate that the PRID 60801. Am I right?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] Could you please help me the mailing address as well please?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mm, got it.
[CUSTOMER][NEUTRAL] And uh could you please help me the member effective and termination of shop policy.
[AGENT][NEUTRAL] Effective date on this plan is [PII] and there is no termination date.
[CUSTOMER][NEUTRAL] Got it. Can you please uh help me in providing the, what is the time you finding limit to submit the claim TFL.
[AGENT][NEUTRAL] There is no no TFL?
[CUSTOMER][NEUTRAL] Got it.
[CUSTOMER][NEUTRAL] OK, [PII] move on the claim. It's for different data service in the bill amount.
[AGENT][NEUTRAL] Yes, what is the next date of service and build them out?
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][POSITIVE] Yeah, just give me a second, please. I will help you with that information as well.
[CUSTOMER][NEUTRAL] The next date of service is going to be?
[CUSTOMER][NEUTRAL] Uh, it's, uh, March, I'm sorry, it's [PII] with the bill amount of $237 even as well.
[AGENT][POSITIVE] Thank you one moment.
[AGENT][NEUTRAL] And there is no claim on file for data service for [PII].
[CUSTOMER][NEUTRAL] OK, in this case, I will, uh, submit the claim to the payer ID because we have been submitted the claim through PayPal. But upon checking, you are showing that you have a payer ID 60801. Definitely, I will defer the claim with the payer ID along with the primary EOB. Got it. Mhm.
[AGENT][POSITIVE] That is correct.
[CUSTOMER][POSITIVE] Got it. Thank you, [PII].
[AGENT][NEUTRAL] You're welcome and is there anything else?
[CUSTOMER][NEUTRAL] Uh, uh, thank you, [PII]. You have been to provided the call reference.
[AGENT][NEUTRAL] Uh yes, you would use my name and today's date for your call reference number.
[CUSTOMER][NEUTRAL] No, that's it all the information I need.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] OK, well then thank you again for calling APL and I hope you have a nice rest of your day, [PII].
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] You too. Bye for now.
[AGENT][POSITIVE] Thank you. Bye-bye.