AccountId: 011433970860
ContactId: 3427301e-2bc2-4029-9977-def895745b7b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 571530 ms
Total Talk Time (AGENT): 182587 ms
Total Talk Time (CUSTOMER): 209529 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/11/3427301e-2bc2-4029-9977-def895745b7b_20250311T20:02_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh, this is [PII] and [PII] calling from office. It's regarding the clients status. Yes, my name is [PII].
[AGENT][NEUTRAL] I'm sorry, I can't
[AGENT][NEUTRAL] What is your name?
[CUSTOMER][NEUTRAL] So.
[AGENT][NEUTRAL] OK, [PII], and you're needing claim status, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Yes, I can help you with that and more, what is your callback number?
[CUSTOMER][NEUTRAL] The callback number is [PII].
[CUSTOMER][NEUTRAL] One second.
[CUSTOMER][NEUTRAL] The callback number is [PII].
[AGENT][NEUTRAL] Thank you and how many claims marked do you have to check status on?
[CUSTOMER][NEUTRAL] There's the only one claim I have for to check claim status.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right. And what is that member's policy number, please, [PII]? I can help you with this.
[CUSTOMER][NEUTRAL] Policy number
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] The policy number is 02047361.
[CUSTOMER][NEUTRAL] ML 7.
[AGENT][POSITIVE] Thank you one moment please.
[AGENT][NEUTRAL] And any information that is provided would be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] Reservation name is [PII]. The date of birth is [PII].
[AGENT][POSITIVE] Thank you one moment.
[CUSTOMER][NEUTRAL] What
[CUSTOMER][NEGATIVE] I'm not gonna.
[AGENT][NEUTRAL] And what is the date of service and total bill amount for her place?
[CUSTOMER][NEUTRAL] Uh, the date of service is [PII] and the bill amount is $3750 even.
[AGENT][NEUTRAL] $3750 even, is that correct?
[CUSTOMER][POSITIVE] Yes, you are correct.
[AGENT][NEUTRAL] OK, thank you. One moment.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] And
[AGENT][NEUTRAL] OK, so there is no claim on file for her for that data service and that total bill amount mark.
[CUSTOMER][NEUTRAL] Sorry, this is a no claim on file.
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] And when you do submit the claim to APL for review, then we must also have you, you will also need to send rather the primary insurance company's explanation of benefits as well.
[CUSTOMER][POSITIVE] Thank
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then once we have processed our claim, you can check our claim status online by going to our portal which is located at [PII].
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] OK. Uh, could you please verify that the patient is uh active for the data service?
[AGENT][NEUTRAL] Yes, this policy is active with an effective date of [PII].
[CUSTOMER][NEUTRAL] 22 [PII].
[AGENT][NEUTRAL] Yes, yes.
[CUSTOMER][NEUTRAL] One second.
[CUSTOMER][NEUTRAL] And the member ID and the billing address is correct?
[AGENT][NEUTRAL] What is the mailing address that you have?
[CUSTOMER][NEUTRAL] I know
[CUSTOMER][NEUTRAL] One second.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] That is uh [PII].
[AGENT][NEUTRAL] No, sir. That's not correct. Yes, so that is an old address.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Could you please provide mailing?
[AGENT][NEUTRAL] The correct mailing address is [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII], no, sir.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Could you please, could you, could you please repeat [PII]?
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Yes sir, did you hear it [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] The zip code is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And the payer ID?
[AGENT][NEUTRAL] 60801.
[CUSTOMER][NEUTRAL] 60801.
[CUSTOMER][NEUTRAL] OK. And the DA for this.
[AGENT][NEUTRAL] I'm sorry, did you ask for the reference number?
[CUSTOMER][NEUTRAL] No, no, no, no. uh, uh, what is the TFL for the claim submission?
[AGENT][NEUTRAL] OK.
[AGENT][NEGATIVE] There is no timely filing?
[CUSTOMER][NEUTRAL] So how many days for this?
[AGENT][NEUTRAL] 0. There is, yes sir, there is no time limit, no timely filing limit with APL.
[CUSTOMER][NEUTRAL] Timely limit.
[CUSTOMER][NEUTRAL] Not in TFL.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, can, can you expect, accept the paper claims as well?
[AGENT][NEUTRAL] Yes, sir, because we will have to have a copy of the primary insurance company's explanation of benefits as I explained to you.
[CUSTOMER][NEUTRAL] OK. Yeah I need to submit claim through uh paper claim?
[AGENT][NEUTRAL] You may submit it either way, but we must have a copy of the primary insurance company's explanation of benefits as well.
[CUSTOMER][NEUTRAL] While submitting the claim, uh claim through paper, need to submit the primary UV as well. Is that correct?
[AGENT][POSITIVE] Correct. That is correct.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Uh, could you please once verify the mailing address?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] City
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, you left this, yes, the city is two words, [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] City.
[CUSTOMER][NEUTRAL] OK. ZIP code is [PII] and the payer ID is 60801. And then no TFL for this, you need to submit paper claim with paper primary OB.
[AGENT][NEUTRAL] Co
[AGENT][POSITIVE] Correct.
[AGENT][POSITIVE] Correct.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Give me 1 2nd, please.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] And is there anything else that I can help you with today, [PII]?
[CUSTOMER][NEUTRAL] Sorry, I didn't know anything for today, [PII]. Could you please spell your name?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] ER
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]. And uh could you please provide me a reference number?
[AGENT][NEUTRAL] My name and today's date?
[CUSTOMER][NEUTRAL] [PII], today's name.
[CUSTOMER][POSITIVE] OK. Thank you for helping out this, for this claim.
[AGENT][POSITIVE] Well, you're very welcome. Yes, [PII], so that is all I can help you with. Thank you again for calling APO and I hope you have a very nice rest of your day.
[CUSTOMER][POSITIVE] Thank you so much. Uh bye-bye for today.
[AGENT][NEUTRAL] Uh-huh. Bye-bye.