AccountId: 011433970860
ContactId: 28af4ea2-eb5f-4904-a8db-b0736b40a6d3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 394459 ms
Total Talk Time (AGENT): 145183 ms
Total Talk Time (CUSTOMER): 115340 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/07/28af4ea2-eb5f-4904-a8db-b0736b40a6d3_20250207T16:12_UTC.wav
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[AGENT][POSITIVE] Thank you for calling APL this is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII], [PII] initial to my last name is [PII], calling from provider's office that is Stone Springs Hospital Center to check on the claim status.
[AGENT][NEUTRAL] OK, I could check on a claim for you. I'm sorry, you did say your name was [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, uh, can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] It is [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you and do you have the policy number?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] It is 021-952-88 M as in Mike, L as in Lima.
[CUSTOMER][NEUTRAL] 8
[AGENT][NEUTRAL] Thank you and what was the name and date of birth for the insured?
[CUSTOMER][NEUTRAL] Uh first name is [PII]. And last name is [PII].
[CUSTOMER][NEUTRAL] And date of birth is [PII].
[AGENT][NEUTRAL] Alright, thank you for verifying that [PII]. What was the date of service for this claim?
[CUSTOMER][NEUTRAL] It is
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yes, it is [PII].
[AGENT][NEUTRAL] OK, and the uh bill amount please.
[CUSTOMER][NEUTRAL] It is $9,091.07.
[AGENT][NEUTRAL] 9,091 7 cents. OK, uh, so the policy number you gave me, [PII] actually terminated in [PII]. If you give me one moment, I'll see if they had one that was active at that time. Give me just a moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, they did give me just a moment let me try to find this claim.
[CUSTOMER][POSITIVE] OK. Take your time.
[AGENT][NEUTRAL] OK [PII], I'm not showing that we received a claim from y'all for the state of service. Um, I can give you that correct policy number though, uh, that was active at that service. Let me know when you're ready.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Yes, I'm ready.
[AGENT][NEUTRAL] OK, it is 02.
[AGENT][NEUTRAL] 31
[AGENT][NEUTRAL] 9946.
[CUSTOMER][NEUTRAL] OK. There is no claim on file, right?
[AGENT][NEUTRAL] Right, we've not received the claim from you.
[CUSTOMER][NEUTRAL] OK. In order to resubmit, I want a few details. May I get the timely filing limit?
[AGENT][NEGATIVE] So there is no timely filing limit.
[CUSTOMER][NEUTRAL] OK. May I get the payer ID?
[AGENT][NEUTRAL] Her ID is 60801.
[CUSTOMER][NEUTRAL] OK. May I get the mailing address?
[AGENT][NEUTRAL] Mailing address is [PII].
[AGENT][NEUTRAL] And that is in [PII] City, [PII].
[AGENT][NEUTRAL] The zip code is [PII].
[AGENT][NEUTRAL] And I've also got a fax number if you'd like [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Fax number is [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] OK. May I get the effect and term date of the patient?
[AGENT][NEUTRAL] Yes, so this policy's effective date was [PII].
[AGENT][NEUTRAL] And it is currently active.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] May I get the patient's plan type?
[AGENT][NEUTRAL] Yes, this is a secondary medical policy.
[AGENT][NEUTRAL] So in order to um process this claim, we would need the EOB from their primary insurance.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, next time I get the, mhm.
[CUSTOMER][NEUTRAL] Um, group name or group ID?
[AGENT][NEUTRAL] Yes, one moment.
[AGENT][NEUTRAL] OK, so the group number is 24149.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then the group name is Mexican.
[AGENT][NEUTRAL] Gastronomy.
[AGENT][NEUTRAL] International
[CUSTOMER][NEUTRAL] OK. I get the call?
[AGENT][NEUTRAL] Reference number would just be my first name, last initial, and today's date. Uh so my name is spelled [PII] Was there anything else I could help you with, Leah?
[CUSTOMER][POSITIVE] No, thank you so much for your assistance.
[AGENT][POSITIVE] Of course, thanks for calling APL. I hope you have a great rest of your day.
[CUSTOMER][NEUTRAL] OK. Bye.
[AGENT][POSITIVE] Thank you, bye bye.