AccountId: 011433970860
ContactId: 24a9e0a2-36f6-4823-a680-52553c47d96d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 486739 ms
Total Talk Time (AGENT): 150139 ms
Total Talk Time (CUSTOMER): 135311 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/14/24a9e0a2-36f6-4823-a680-52553c47d96d_20250114T21:29_UTC.wav
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[AGENT][NEUTRAL] Afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Your name is?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] OK. I'm calling regarding a claim status. So before we get started, uh I just wanted to inform that this call is being recorded for quality and training purposes. Can we continue?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, that is fine. So you're needing to check claim status, is that correct?
[CUSTOMER][NEUTRAL] Yes, your name again? Can you spell it?
[AGENT][NEUTRAL] [PII] And your name?
[CUSTOMER][NEUTRAL] [PII], OK. My name is [PII].
[AGENT][NEUTRAL] Spell your name for me, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and [PII], what is your callback number?
[CUSTOMER][NEUTRAL] It's [PII] with an extension [PII].
[AGENT][NEUTRAL] I'm sorry, [PII]. Is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Thank you. And how many coins right do you have to check status?
[CUSTOMER][NEUTRAL] One.
[AGENT][NEUTRAL] OK. And what is that member's policy number? I can help you with this.
[CUSTOMER][NEUTRAL] 02221656 M as in Mike 18.
[AGENT][POSITIVE] Thank you, one moment please.
[CUSTOMER][NEUTRAL] What is the, what is the initials of the last name?
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And [PII] and the information that I provide for you today will be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] It's [PII] and date of birth is [PII].
[AGENT][NEUTRAL] Thank you. And the date of service and total bill amount please.
[CUSTOMER][NEUTRAL] [PII] and the bill uh bill amount is $1,019 even.
[AGENT][POSITIVE] Thank you, one moment.
[AGENT][NEUTRAL] So, just a moment, please.
[AGENT][NEUTRAL] And what is the provider facility name?
[CUSTOMER][NEUTRAL] Vital MD Groups holding LLC.
[AGENT][NEUTRAL] OK, I do not have a claim on, let's see, let me, let me double check one thing, Roj, just one moment.
[CUSTOMER][NEUTRAL] It was billed on [PII] to your insurance and I guess there's a denial also.
[AGENT][NEUTRAL] OK, I don't have a claim on file for this member for that bill's amount.
[CUSTOMER][NEUTRAL] Uh, $1,019.
[AGENT][NEUTRAL] That is correct. I do not have a claim on file for that bill amount.
[CUSTOMER][NEUTRAL] OK, is there a 901.72 bill amount $901.72.
[AGENT][NEUTRAL] No, sir.
[CUSTOMER][NEUTRAL] Like
[AGENT][NEGATIVE] There is not.
[AGENT][NEUTRAL] Roger, are you still there?
[AGENT][NEUTRAL] Hello.
[CUSTOMER][NEGATIVE] Just a second. Sache panchey.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Uh, did it.
[CUSTOMER][NEUTRAL] Can the USC global because of call on a claiming process it need to have some more time now love us.
[CUSTOMER][NEUTRAL] Are they.
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Yes, sir, I'm here.
[CUSTOMER][POSITIVE] I'm so sorry. Yes.
[AGENT][NEUTRAL] Are you speaking?
[CUSTOMER][NEUTRAL] So sorry.
[AGENT][NEUTRAL] That's OK.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Yeah, so there's no claim on file for even $901.72.
[AGENT][NEUTRAL] Correct, there is no claim on file.
[CUSTOMER][NEUTRAL] OK. Can I get the PO box, means payer ID?
[AGENT][NEUTRAL] Yes, the claim's mailing address is [PII].
[AGENT][NEUTRAL] That is in [PII].
[AGENT][NEUTRAL] And the zip code is [PII].
[CUSTOMER][NEUTRAL] OK. Just a second.
[CUSTOMER][NEUTRAL] Can I get the payer ID?
[AGENT][NEUTRAL] Payer ID is 60801.
[CUSTOMER][NEUTRAL] 60801. OK. Can I get a call reference?
[AGENT][NEUTRAL] Yes, and.
[AGENT][NEUTRAL] Yes, but there are a couple of other things that I do need to tell you, [PII], because this is a supplemental policy. You must also submit a copy of the primary insurance company's explanation of benefits along with the claim.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then you can check claim status by going to our portal at [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. Well, can I help you with anything else today?
[AGENT][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Can you check that, do you have this date of service available? It's [PII].
[AGENT][NEUTRAL] Is it, you have another data service for the same patient?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] What's the what's the data service again?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Total bill amount.
[CUSTOMER][NEUTRAL] $619 even.
[AGENT][NEUTRAL] 619. Is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] One moment, please.
[AGENT][NEUTRAL] OK, so this claim was received. One moment, I'll provide that information.
[CUSTOMER][NEUTRAL] No, you have the claim. I just wanted that. Uh, what is the call reference?
[AGENT][NEUTRAL] My name in today's date.
[CUSTOMER][NEUTRAL] OK. Your name is [PII] yes today's date, OK.
[AGENT][POSITIVE] Yes, that is correct. So you're welcome, [PII]. Thank you again for calling APL and I hope that you have a very nice evening.
[CUSTOMER][POSITIVE] Thank you so much.