AccountId: 011433970860
ContactId: 34f9d3aa-173b-4f38-bac2-322cbeba3fb7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 433470 ms
Total Talk Time (AGENT): 190289 ms
Total Talk Time (CUSTOMER): 122592 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/04/34f9d3aa-173b-4f38-bac2-322cbeba3fb7_20250304T20:28_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII]. I'm calling from provider office to check on a claim shares [PII].
[AGENT][NEUTRAL] Hi.
[AGENT][NEUTRAL] OK. May I have your name again, please?
[CUSTOMER][NEUTRAL] My name is [PII]. It's [PII]
[AGENT][POSITIVE] Thank you a lot. What is your callback number if we are disconnected please?
[CUSTOMER][NEUTRAL] [PII]. It is the direct line with the extension.
[AGENT][NEUTRAL] Thank you. What is that policy number, please?
[CUSTOMER][NEUTRAL] Uh, that is 1481871.
[AGENT][NEUTRAL] OK, let me repeat that to you just to confirm I have that correct. I have that as 1481871.
[CUSTOMER][NEUTRAL] I get
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Thank you. I verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Uh, [PII] [PII].
[AGENT][NEUTRAL] OK, thank you very much for the verification process. Lo that and again you're calling for claim status. I can assist you. May I have that date of service and the total charge amount please?
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] [PII] with a bill amount of $163.
[AGENT][NEUTRAL] OK, let me just repeat that to confirm. I have that as [PII] and the amount of $163.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, thank you so much. Give me one moment please, and also to let you know while it late up you are able to check claim status by visiting our secure portal at [PII] and also on that website you'll be able to obtain EOBs as well.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK, OK.
[AGENT][NEUTRAL] Now, let me take a look here. Give me one moment.
[CUSTOMER][NEUTRAL] Uh huh.
[AGENT][NEUTRAL] Um, the policy number that you provided me has termed, and I do not show that claim on this policy number. If you could bear with me, I can check to see if there's an active policy number within that date range for you, please.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh, for the patient, for the patient you are shedding?
[AGENT][NEUTRAL] For yes, for the patient you're calling in regards to, yes.
[CUSTOMER][NEUTRAL] OK. Uh, OK, you can check, uh, but, uh, any, uh, can you please, uh, spell your name?
[AGENT][NEUTRAL] Of course, it is [PII].
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Oh [PII]. Sorry, I, I forgot.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] That's OK, no problem, no problem. Now, before I look for another policy number, um, would you like to know the effective date and term date of this policy that you provided me?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Sure, sure, sure.
[CUSTOMER][NEUTRAL] Uh, what the effective date?
[AGENT][NEUTRAL] OK, effective date shows [PII].
[AGENT][NEUTRAL] And this policy term, [PII].
[AGENT][NEUTRAL] Bear with me please.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you.
[AGENT][POSITIVE] One moment, I'm almost done thank you.
[AGENT][NEUTRAL] OK, now I was able to find a, an active policy number. Can I provide that to you, please?
[CUSTOMER][NEUTRAL] Any moment.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] What is the new member ID?
[AGENT][NEUTRAL] It is 1988265.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And uh the
[CUSTOMER][NEUTRAL] Electro the payer ID will be.
[CUSTOMER][NEUTRAL] 645-556, right?
[AGENT][NEUTRAL] No, no, the payer ID is 60801.
[CUSTOMER][NEUTRAL] Give me just a moment please.
[AGENT][NEUTRAL] OK, of course.
[CUSTOMER][NEUTRAL] Uh, this is the secondary insurance, right?
[AGENT][NEUTRAL] Yes, yes. Would you like to effect the date?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, first of all, what is the mailing address of the
[CUSTOMER][NEUTRAL] To file a claim?
[AGENT][NEUTRAL] I'm sorry, let me check to see if the claim is under this policy number that I provided to you. One moment, OK? One moment, thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, I do not show that we have that claim on file. Now let me provide you with our mailing address when you're ready and fax number and.
[AGENT][NEUTRAL] What
[CUSTOMER][NEUTRAL] Mhm. What is the mailing address?
[AGENT][NEUTRAL] OK, it is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII] City, [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Give me just a moment.
[AGENT][NEUTRAL] Of course.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] 30
[CUSTOMER][NEUTRAL] [PII], right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Payer ID is 60801. What a time file limit to submit a claim.
[AGENT][NEGATIVE] There's no timely filing to submit a claim.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No TXL
[CUSTOMER][NEUTRAL] For claim
[AGENT][NEUTRAL] Now would you also like our fax number? I didn't provide that to you.
[CUSTOMER][POSITIVE] No, no worry, I don't need that.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And what is the new member ID effective date?
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII] are still active, right?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] about
[AGENT][NEUTRAL] And also that you can actually file claims on that website as well [PII].
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Give me a moment. I will I will reconfirm the member ID that is [PII], right?
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] Thank you. And uh what will be the call reference number?
[AGENT][NEUTRAL] Of course.
[AGENT][NEUTRAL] We do not provide a call reference numbers like, but you can use my name in today's date. My last initial is [PII].
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] Is there anything else I can assist you with with this call?
[CUSTOMER][POSITIVE] No, no, thank you, thank you so much have a great day bye bye.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] You're welcome. Thank you so much for calling AP. Have a good day. Thank you, bye bye.