AccountId: 011433970860
ContactId: 353912cb-bd59-441a-af50-fb1ca488ce71
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 449679 ms
Total Talk Time (AGENT): 74702 ms
Total Talk Time (CUSTOMER): 225303 ms
Interruptions: 0
Overall Sentiment: AGENT=-0.2, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/04/353912cb-bd59-441a-af50-fb1ca488ce71_20250604T18:48_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh, hi, [PII]. Uh, this is [PII] and I'm calling from MI clinic. Uh, [PII], I have a few set of claims to check, uh, for the same member.
[AGENT][NEUTRAL] OK, [PII], I can help you with claim status. Do you have a good callback number?
[CUSTOMER][NEUTRAL] Yeah. Uh, that is going to be [PII]. Uh, it's a direct line.
[AGENT][NEUTRAL] OK, thank you. And the policy number for that patient?
[CUSTOMER][NEUTRAL] Yeah. Uh, that is going to be 02587781.
[AGENT][NEUTRAL] And patient name and date of birth?
[CUSTOMER][NEUTRAL] Uh, the member's name is, uh,
[CUSTOMER][NEUTRAL] Yup. Uh, I will spell out the first name, that is uh [PII]. Last name is [PII], and the date of birth will be [PII].
[AGENT][NEUTRAL] OK, thank you and the data service and bill charges?
[CUSTOMER][NEUTRAL] Yeah. Uh, for the first claim, it's on [PII], uh, with the total bill amount of uh $4445.41.
[AGENT][NEUTRAL] Looks like I don't have that date of service on file.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, let me check, uh, how we send this, uh.
[CUSTOMER][NEUTRAL] Claim
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Electronic.
[CUSTOMER][NEUTRAL] OK. Uh, this was in electronically and I have the pay ID which is 42011.
[AGENT][NEUTRAL] Uh, uh, payer ID should be 60801.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That is 60.
[AGENT][NEUTRAL] 801.
[CUSTOMER][NEUTRAL] OK, that's the correct pay ID right?
[AGENT][NEUTRAL] It's
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] So, by the way, uh, OK. Uh, is that the member is active for that, uh, date of service?
[AGENT][POSITIVE] Uh yes, policy is effective.
[AGENT][NEUTRAL] Uh, effective [PII] and currently active.
[CUSTOMER][NEUTRAL] OK. Uh, shall we move to the other one then?
[AGENT][NEUTRAL] A different policy numbers?
[CUSTOMER][NEUTRAL] Uh, no, no, no. Same number.
[AGENT][NEUTRAL] Oh, OK, uh, data service and bill charges?
[CUSTOMER][NEUTRAL] Yeah. Uh, this one, it's on [PII], and the total bill amount is uh $445.41.
[AGENT][NEUTRAL] Don't have that on file either. so is this for a facility charge or uh a physicians?
[CUSTOMER][NEUTRAL] Uh, these are for physician, yes, it's not a hospital, uh, claim, it's a professional claim.
[AGENT][NEUTRAL] OK, yeah, I don't have that claim on file either.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Yup. Uh, by the way, may I know the initial, uh, time limit there, sir?
[AGENT][NEGATIVE] There's no timely filing limit.
[AGENT][NEGATIVE] Secondary or it's a supplemental policy, so there's no timely filing.
[CUSTOMER][NEUTRAL] Oh, so this member should have primary pay, right?
[AGENT][NEUTRAL] Uh, this is a supplemental policy. I don't know if they have primary.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, yup. Uh, shall you check the other one as well?
[AGENT][NEUTRAL] OK, the data service and dollar amount.
[CUSTOMER][NEUTRAL] Yup. Uh, so the that claim, uh, it's on [PII], and the total bill amount is uh $444.41.
[AGENT][NEUTRAL] Uh, no claim on file.
[CUSTOMER][NEUTRAL] Uh, I'm sorry. Uh, the bill amount should be $445.41.
[AGENT][NEUTRAL] Yeah, we don't have that
[CUSTOMER][POSITIVE] Uh, the service is correct.
[AGENT][NEUTRAL] Yeah, we don't have that date of service on file.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. And uh
[CUSTOMER][NEUTRAL] Yup. Uh, I have 3 more, uh, for this man.
[AGENT][NEUTRAL] OK, the data service.
[CUSTOMER][NEUTRAL] Yeah, uh, for that one, so it's on [PII].
[CUSTOMER][NEUTRAL] And the total charge amount is $140 even.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Um, no claim on file.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, the next one, yup. Uh, it's on [PII], and the total bill amount is at $362 even.
[AGENT][NEUTRAL] And no claim on file.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And the last claim, uh, it's on [PII]. And the total charge amount is uh $697.91.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] Um, no claim on file either.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Yeah. Uh, so that's all the claims I have. And, uh, [PII], uh, may I know your last name, initial, and the call reference number?
[AGENT][NEUTRAL] A call reference number is my name, [PII]. First initial to last name is D as in Delta, and today's date.
[CUSTOMER][POSITIVE] OK, that's all then. Thank you very much. Uh, take care. Bye for now.
[AGENT][POSITIVE] Thanks for calling APL. You too. Bye-bye.