AccountId: 011433970860
ContactId: 32f93cce-de6b-4910-b6f2-8ba3e220697b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 420829 ms
Total Talk Time (AGENT): 123294 ms
Total Talk Time (CUSTOMER): 147463 ms
Interruptions: 2
Overall Sentiment: AGENT=0.2, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/19/32f93cce-de6b-4910-b6f2-8ba3e220697b_20250519T21:35_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from the provider's office to know the general claim status.
[AGENT][NEUTRAL] OK, I can check on a claim for you. I'm sorry, what did you say your name was?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, uh, [PII], can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And then do you have the policy number?
[CUSTOMER][NEUTRAL] 017
[CUSTOMER][NEUTRAL] 589977
[AGENT][NEUTRAL] OK and then what was the name and date of birth for the member please?
[CUSTOMER][NEUTRAL] The name of the members will go be [PII].
[CUSTOMER][NEUTRAL] And the date of birth [PII].
[AGENT][NEUTRAL] OK, thank you for verifying that and what was the date of service for this claim?
[CUSTOMER][NEUTRAL] [PII], I'm sorry, [PII].
[AGENT][NEUTRAL] [PII] and then what was that bill amount, please?
[CUSTOMER][NEUTRAL] $40,780.64.
[AGENT][NEUTRAL] OK thank you one moment.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, just to confirm that was [PII] correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, we have not received a claim for that date of service, [PII].
[CUSTOMER][NEUTRAL] Uh, just give me a moment.
[CUSTOMER][NEUTRAL] you
[CUSTOMER][NEUTRAL] They
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] You.
[CUSTOMER][NEUTRAL] Yes, the date of birth is, um sorry, the date of service is [PII]. There is no claim of. Just can you please provide me we submit the claim through the mailing address [PII].
[CUSTOMER][NEUTRAL] [PII]. Is that the correct one?
[AGENT][NEUTRAL] No that is not. Let me know when you're ready and I'll get you our correct uh mailing address.
[CUSTOMER][NEUTRAL] Uh, just, can you please give me a moment?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] Just, can you please provide me number is available for the date of service?
[AGENT][NEUTRAL] I'm sorry, what was that?
[CUSTOMER][NEUTRAL] Member is eligible for the date of service?
[AGENT][NEUTRAL] Yes, this policy's effective date was [PII] and it is currently active.
[CUSTOMER][POSITIVE] Thank you so much. Just give me a second. It's completed.
[CUSTOMER][NEUTRAL] Can you, uh, can you please provide me, is there any payer IDs available?
[AGENT][NEUTRAL] Pay ID is 60801.
[CUSTOMER][NEUTRAL] And can you please, and the member ID which I provided, which is correct?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] And can you please provide me the claim's mailing address?
[AGENT][NEUTRAL] That is [PII].
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] That is in [PII].
[CUSTOMER][NEUTRAL] Are you
[AGENT][NEUTRAL] Zip code is [PII].
[CUSTOMER][NEUTRAL] That is [PII]
[CUSTOMER][NEUTRAL] I'm really sorry. Can you please repeat the
[CUSTOMER][NEUTRAL] ZIP code once again.
[AGENT][NEUTRAL] Zip code is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And can you please provide me the, is there any group name?
[AGENT][NEUTRAL] Uh, let me get that one moment.
[AGENT][NEUTRAL] Group name is [PII], that is [PII]
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Can you please provide me group ID?
[AGENT][NEUTRAL] Group number is 17545.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And can you please provide me the member's plan effective and the term date?
[AGENT][NEUTRAL] Effective date was [PII] and it is currently active.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh, which type of plan it is, it is H or that your plan?
[AGENT][NEUTRAL] It's neither. This is a secondary medical policy, so it is designed to help with co-pay, deductible and co-insurance after major medical pays. It follows major medical guidelines.
[CUSTOMER][NEUTRAL] more than
[CUSTOMER][NEUTRAL] Can you please provide me the timely filing limit to submit the claim?
[AGENT][NEGATIVE] There is no timely filing limit.
[CUSTOMER][NEUTRAL] And the name and the date of birth which I provided you, is that correct?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Can you please spell your name?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] It you.
[CUSTOMER][POSITIVE] Thank you so much for providing me all these details. And can I get the call reference number for this call?
[AGENT][NEUTRAL] Reference number would be my first name, last initial, [PII]'s date, uh, so my last initial is [PII] and was there anything else I could help you with?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] No, thank you so much for providing me all these details.
[AGENT][POSITIVE] Of course, thanks for calling APL have a great rest of your day.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEGATIVE] I don't like this.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah.