AccountId: 011433970860
ContactId: 32818646-097f-4994-9291-5d7b827a173f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 373459 ms
Total Talk Time (AGENT): 104572 ms
Total Talk Time (CUSTOMER): 129845 ms
Interruptions: 1
Overall Sentiment: AGENT=0.5, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/28/32818646-097f-4994-9291-5d7b827a173f_20250528T16:36_UTC.wav
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[AGENT][POSITIVE] Good morning. Thanks for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from provider's office for the claim status. Can you please spell out your name?
[AGENT][NEUTRAL] Sure, [PII] last initial [PII] and I can verify claim status for you [PII]. What is that policy number, please?
[CUSTOMER][NEUTRAL] Policy number starting with 018.
[CUSTOMER][NEUTRAL] 642-31, M as in Mary, L as in Lima, number 8.
[AGENT][NEUTRAL] OK, thank you. And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] Yeah, [PII].
[AGENT][NEUTRAL] OK, and the patient's name, date of birth.
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] OK, thank you. And what was the date of service and the amount of the charge?
[CUSTOMER][NEUTRAL] [PII] with $238 even and it is a crossover claim actually.
[AGENT][NEUTRAL] What is the balance after primary?
[CUSTOMER][NEUTRAL] After paying the balance, it is $40.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] You said the date of service is [PII]?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, I don't show that claim has been received. Can you verify the mailing address it was submitted to?
[CUSTOMER][NEUTRAL] Yeah, of course. The mailing address which we have submitted is [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Uh, that is correct. And if you like I can give you our fax number if you like to fax the claim to our office.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] So, is it a claim not on file?
[AGENT][NEUTRAL] We have not received the claim. Would you like to have our fax number? You can fax the claim?
[CUSTOMER][NEUTRAL] Yeah, OK. Could you please
[CUSTOMER][NEUTRAL] Go ahead.
[AGENT][NEUTRAL] Fax number [PII].
[CUSTOMER][NEUTRAL] OK. May I know the patient effective and termination dates quickly?
[AGENT][NEUTRAL] Effective date, [PII] policy is active.
[CUSTOMER][NEUTRAL] Still active.
[CUSTOMER][NEUTRAL] Is there a time limit to submit the claim?
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] No, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh OK, I have one more claim. Can you help me with that?
[AGENT][NEUTRAL] Is it for the same patient or a different patient?
[CUSTOMER][NEUTRAL] Different patient and provider and uh what about the caller reference number for this?
[AGENT][NEUTRAL] Uh, one moment.
[AGENT][NEUTRAL] Uh, you may use my name with today's date as reference.
[CUSTOMER][NEUTRAL] OK, got it.
[CUSTOMER][NEUTRAL] Uh, we shall move to the next patient.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and what is next policy number?
[CUSTOMER][NEUTRAL] 01678796.
[AGENT][NEUTRAL] Patient's name, date of birth?
[CUSTOMER][NEUTRAL] And [PII]. [PII].
[AGENT][NEUTRAL] OK, date of service amount of the charge.
[CUSTOMER][NEUTRAL] [PII] with $483 even, and even it is also a crossover claim.
[AGENT][NEUTRAL] Balance after primary?
[CUSTOMER][NEUTRAL] Balance of the primary is $26.43.
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And what is the name of the provider's office?
[CUSTOMER][NEUTRAL] For this name is [PII] and the facility name is Claban Clinic Foundation.
[AGENT][NEUTRAL] I do not show we received that claim, and can you verify the address that was sent to?
[CUSTOMER][NEUTRAL] I think even when it was sent to the same address previously which I stated, I mean verified.
[AGENT][NEUTRAL] OK. Uh, you may resubmit by mail or you can fax it to our office.
[CUSTOMER][NEUTRAL] OK. Uh, what will be the effective and termination dates of this patient?
[AGENT][NEUTRAL] Effective date [PII], policy is active.
[CUSTOMER][NEUTRAL] OK. Got it. And the caller reference number is the same, even at no timely filing limit.
[AGENT][NEUTRAL] You may use my name in today's date, correct.
[CUSTOMER][POSITIVE] Yeah. Yes, yeah. Got it.
[CUSTOMER][POSITIVE] Thank you for providing the information.
[AGENT][POSITIVE] You're welcome. Thanks for calling APL. Have a great day.
[CUSTOMER][POSITIVE] Have a great day. Bye-bye.
[AGENT][NEUTRAL] Mhm.