AccountId: 011433970860
ContactId: 30a7b2c2-9500-4e93-95c0-704fbccd1956
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 336500 ms
Total Talk Time (AGENT): 131933 ms
Total Talk Time (CUSTOMER): 116438 ms
Interruptions: 1
Overall Sentiment: AGENT=1.2, CUSTOMER=1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/04/30a7b2c2-9500-4e93-95c0-704fbccd1956_20250204T21:06_UTC.wav
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[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. This is [PII]. Very good afternoon. My name is [PII]. I'm calling from provider's office. I'm checking up on the claims.
[AGENT][NEUTRAL] OK, [PII], you're needing claim status, is that correct?
[CUSTOMER][POSITIVE] Yes that's right.
[AGENT][POSITIVE] Yes, I can help you with that, [PII] and what is your callback number, please?
[CUSTOMER][NEUTRAL] It is [PII] and that's my direct line.
[AGENT][NEUTRAL] Thank you and how many claims, [PII], do you have to check status on?
[CUSTOMER][NEUTRAL] I have only one.
[AGENT][NEUTRAL] OK, yes, I can help you with that and what is the member's policy number?
[CUSTOMER][NEUTRAL] Policy number is 02337498 M as in Mike L as in Lima 8.
[AGENT][NEUTRAL] OK thank you one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And any information, [PII], that I do provide for you today would be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] Patients first name is [PII]. Last name is [PII].
[CUSTOMER][NEUTRAL] And the patient date of birth is [PII].
[AGENT][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Um
[AGENT][NEUTRAL] What is the data of service and total bill amount for her, please, [PII]?
[CUSTOMER][NEUTRAL] Claim data services [PII] and the total bill amount is $224 even.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And again you said it was for 12-1120 24, is that correct?
[CUSTOMER][POSITIVE] That's correct, yes.
[AGENT][NEUTRAL] OK, we do not have a claim on file for her [PII] for that data service.
[AGENT][NEUTRAL] And because this is a supplemental policy to their primary insurance when you do file a claim with us, you will also need to send us a copy of her primary insurance company's explanation of benefits because we do have to have that as well.
[CUSTOMER][NEUTRAL] What
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] OK. Um, for your current knowledge, I have submitted a claim to electronically from outside on [PII] and I used the payer ID number.
[CUSTOMER][NEUTRAL] 00010. Is it correct?
[AGENT][NEUTRAL] No, sir, our payer ID for APL is 60801.
[CUSTOMER][NEUTRAL] 60801, is that correct?
[AGENT][NEUTRAL] 60801, that is correct.
[CUSTOMER][NEUTRAL] For physical mailing address, what is that?
[AGENT][NEUTRAL] What do you show on file?
[CUSTOMER][NEUTRAL] Um, so you.
[CUSTOMER][NEUTRAL] For months.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So, I'm showing here [PII] [PII].
[AGENT][NEUTRAL] Right, so that's an
[AGENT][NEUTRAL] Yes, so that's an old address.
[CUSTOMER][NEUTRAL] Oh,
[AGENT][NEUTRAL] The correct mailing address for claims is [PII].
[CUSTOMER][NEUTRAL] So may I have you
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] That's in [PII].
[AGENT][NEUTRAL] The zip code is [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And may I know the timely filing limit for secondary claims?
[AGENT][NEGATIVE] There is no timely filing limit?
[CUSTOMER][POSITIVE] That's good.
[CUSTOMER][POSITIVE] Thank you so much for that and uh mhm.
[AGENT][NEUTRAL] And then once
[AGENT][NEUTRAL] I'm sorry, go ahead.
[CUSTOMER][NEUTRAL] Do you know the patient, patient is active for the current data service?
[AGENT][NEUTRAL] This policy is active effective [PII].
[CUSTOMER][NEUTRAL] Like the.
[CUSTOMER][NEUTRAL] And no termination date, right?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] And then once we have processed the claims and we do have a portal that you can check claim status and also print our explanation of benefits from and that website that you would go to to set up your account is secured.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] All right. I have your portal.
[AGENT][POSITIVE] Mhm. OK, good.
[CUSTOMER][POSITIVE] OK, thank you so much for asking us on this claim. This is [PII], and can I get your call reference number?
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] Sure, you would use my name along with today's date.
[CUSTOMER][POSITIVE] All right, [PII]. Thank you so much and uh this is [PII]. My last name is [PII]. Thank you so much for your assistance on this claim. I appreciate your patience and time. Have a great day. Bye.
[AGENT][NEUTRAL] Yes, so.
[AGENT][POSITIVE] You're very welcome, [PII], and thank you again for calling APL. I hope you have a nice rest of your day.
[CUSTOMER][NEUTRAL] You
[CUSTOMER][POSITIVE] Thank you, bye.
[AGENT][POSITIVE] You're welcome