AccountId: 011433970860
ContactId: 280524da-00cb-43f2-a0ef-368d17060215
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 293260 ms
Total Talk Time (AGENT): 108463 ms
Total Talk Time (CUSTOMER): 76265 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/06/280524da-00cb-43f2-a0ef-368d17060215_20250306T15:56_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yeah, ma'am. My name is [PII]. I'm calling from provider's office. Uh, I need the claim details about claim status.
[AGENT][NEUTRAL] OK, I can help you with the claim status, and [PII], may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yeah, [PII].
[AGENT][NEUTRAL] Thank you for that. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] 021 91743
[AGENT][NEUTRAL] Thank you and how many claims do you have in total today?
[CUSTOMER][NEUTRAL] Only one.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Yeah, it's [PII], and the date of birth is [PII].
[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 for the claim you like me to check on?
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] And the total bill amount?
[CUSTOMER][NEUTRAL] Let me check. It's $1500 even.
[AGENT][NEUTRAL] $1500?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] Hold on one moment. I'm looking at 2 claims here. And can you verify the name of the provider's office?
[CUSTOMER][NEUTRAL] Yeah, it's ophthalmology consultant.
[AGENT][NEUTRAL] You said ophthalmology consultant?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] What's the tax ID?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] OK, so we received two claims for that data service, um, but the claim, it's a different provider and a different um total bill, so we have not received your claim.
[CUSTOMER][NEUTRAL] OK. And can you please provide me the details regarding under which payer ID and uh
[CUSTOMER][NEUTRAL] Sorry, your email, we can, sorry, mail, we can send the same.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] What is the mailing address to send the claim?
[AGENT][NEUTRAL] So it's [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The zip code is [PII].
[CUSTOMER][NEUTRAL] OK. And is there any way, other way to send the claim like uh electronically and any fax number?
[AGENT][NEUTRAL] Yes, so the payer ID is 60801.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And our fax number is 877.
[AGENT][NEUTRAL] 365.
[AGENT][NEUTRAL] 942 3.
[CUSTOMER][NEUTRAL] OK. And attention?
[AGENT][NEUTRAL] And that's attention
[AGENT][NEUTRAL] Attention APL claims department.
[CUSTOMER][NEUTRAL] OK. And what is the timely filing limit to send the claim?
[AGENT][NEUTRAL] So there's no filing limit as long as the policy is active on the data service, you can file the claim at any time.
[CUSTOMER][NEUTRAL] OK. And is this patient active on data service?
[AGENT][NEUTRAL] Um, [PII]. Hold on one moment.
[AGENT][NEUTRAL] Yes, this policy has been active since [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you so much. And can you please provide me the call reference number?
[AGENT][NEUTRAL] Um, so there's no call reference number, but you can use my name in today's date. The first initial to my last name is [PII].
[CUSTOMER][POSITIVE] OK. Thank you so much.
[AGENT][POSITIVE] You're welcome, sir. Was there anything else I can assist you with today?
[CUSTOMER][POSITIVE] No, thank you so much.
[AGENT][POSITIVE] Alright, well, thanks for calling APL. I hope you have a great day.