AccountId: 011433970860
ContactId: 2fd800fc-cf06-4b42-a305-bca22bcdae0e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 305350 ms
Total Talk Time (AGENT): 130138 ms
Total Talk Time (CUSTOMER): 133033 ms
Interruptions: 4
Overall Sentiment: AGENT=0.4, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/15/2fd800fc-cf06-4b42-a305-bca22bcdae0e_20250415T13:16_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Yes, hi [PII]. My name is [PII] and I'm calling the provider office, and I'm trying to get a status of a medical claim if that's possible.
[AGENT][NEUTRAL] Sure, that's possible. Can I have a callback number for you and that policy number?
[CUSTOMER][NEUTRAL] Sure. The callback number is [PII]. My direct extension will be [PII].
[AGENT][NEUTRAL] And what's the policy number?
[CUSTOMER][NEUTRAL] And the policy number, give me a second, let me pull it up.
[CUSTOMER][NEUTRAL] The policy number, where are you? hmm.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] where are you?
[CUSTOMER][NEUTRAL] Insure family in the group.
[CUSTOMER][NEUTRAL] Um, the policy number is 01659284.
[CUSTOMER][NEUTRAL] ML 8.
[AGENT][NEUTRAL] So that's 1659284. Could you verify that patient's name and date of birth?
[CUSTOMER][NEUTRAL] Uh, the patient name is [PII] or [PII]. It's [PII].
[AGENT][NEUTRAL] And when you're calling to check the status of a claim for what date of service?
[CUSTOMER][NEUTRAL] Oh, this is way back on [PII].
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Is this a facility charge or professional fee? What is your procedure called? What's the procedure called?
[CUSTOMER][NEUTRAL] Oh, it's a provider, professional.
[CUSTOMER][NEUTRAL] Uh, the procedure code is 54405.
[AGENT][NEUTRAL] For [PII], what is the bill amount?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, the total charge for that, that will be, where are you?
[CUSTOMER][NEUTRAL] It's 5,082.
[AGENT][NEUTRAL] I'm not showing the claim on file for that.
[AGENT][NEUTRAL] For the bill amount for the data service, could you verify where you sent it to?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That's fine.
[CUSTOMER][NEUTRAL] It was sent it to it's not for claim but it was sent to PO Box.
[CUSTOMER][NEUTRAL] 248,950 [PII], Ok [PII].
[AGENT][NEUTRAL] That is our billing address, but we don't have a claim on file for [PII] for the bill amount of what did you say it was 5000?
[CUSTOMER][NEUTRAL] 5,082.
[AGENT][NEUTRAL] No, we have a facility charge and other professional fees, but not that one. And what was the uh with that procedure code?
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] OK. That's fine. um.
[AGENT][NEUTRAL] Let me give you our payer ID.
[CUSTOMER][POSITIVE] Sure. But it's gonna be timely fine, so it's fine.
[AGENT][NEUTRAL] Yeah, do your pay ID and the.
[CUSTOMER][NEUTRAL] Cause if I'm gonna send it that way, OK, it's fine. OK. Um, can you
[AGENT][NEGATIVE] Yeah, there's no timely filing because as long as the policy was active, even if the policy was terminated, if it was active.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] The date of service, there's no timely filing here in American Public Life. That's what makes us the best out of all the insurance companies.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK, I'll I'll just.
[CUSTOMER][NEUTRAL] OK, no, so for APL there's no timely filing.
[AGENT][NEUTRAL] So
[AGENT][NEUTRAL] No, there's no time to filing. Like how other insurance companies have 90 days or something of that matter, no time to filing here, that's the best thing about APL and also let me give you the fax number one.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So that way you can send it by fax. You can just send it right now by fax. Let me know when you're ready for it.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Go ahead.
[AGENT][NEUTRAL] It is 1877.
[AGENT][NEUTRAL] 3659423 that's 18773659423 and make sure that you attach the primary EOB because this is a gap.
[CUSTOMER][NEUTRAL] 023.
[AGENT][NEUTRAL] Yes, 187-736-59423. Make sure you attach the primary ELB because this is a gap insurance.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Alright thanks.
[CUSTOMER][NEUTRAL] Alrighty and then um is this possible please spell your name for me and do you have any call reference number?
[AGENT][NEUTRAL] Is there anything
[AGENT][NEUTRAL] My name is [PII] and today's date is a reference. We don't provide reference numbers.
[CUSTOMER][POSITIVE] Alright, thank you so much.
[AGENT][POSITIVE] You're welcome. You're welcome, [PII]. Thanks for calling APO. Have a good day. Goodbye.
[CUSTOMER][POSITIVE] All right bye you too bye.