AccountId: 011433970860
ContactId: 36250416-326c-4003-82ae-0c231904303d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 361739 ms
Total Talk Time (AGENT): 134758 ms
Total Talk Time (CUSTOMER): 115833 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/23/36250416-326c-4003-82ae-0c231904303d_20250523T14:16_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey, hi. This is [PII] speaking from provider's office regarding claim status. Can you spell out your name for me?
[AGENT][NEUTRAL] Sure, it's [PII] Uh, would you mind spelling your name as well?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Got it. OK, and then I can check on a claim for you, [PII], can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes. It's [PII] with an extension [PII].
[AGENT][NEUTRAL] Thank you. And then do you have the policy number?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] It's 01877135 M as in Mary, L as in Lima, 8.
[AGENT][NEUTRAL] OK, and then what was the name and date of birth for the member please?
[CUSTOMER][NEUTRAL] It is uh [PII], [PII].
[AGENT][NEUTRAL] Thank you for verifying that and then what was the date of service for this claim?
[CUSTOMER][NEUTRAL] [PII] for an amount of $394 even.
[AGENT][NEUTRAL] OK, that was [PII] for $394?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, and then what was the uh tax ID for this provider [PII]?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you. One moment.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, so it does not look like we've received that claim, [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Haven't you received the claim?
[AGENT][NEGATIVE] And no, it does not look like we received this claim.
[CUSTOMER][NEUTRAL] OK, can you check in the.
[CUSTOMER][NEUTRAL] Rejection list if the claim has been rejected.
[AGENT][NEUTRAL] No, no, no, it's, it's just that I don't see a claim for that date of service for for that amount from this provider so this claim has not been received.
[AGENT][NEUTRAL] I can give you our mailing address, fax number, and our payer ID.
[CUSTOMER][NEUTRAL] Yeah, that's what I'm saying.
[CUSTOMER][NEUTRAL] Yeah, OK. And uh may I know that uh the, the patient has a primary insurance as UC and it has been crossed over to the American public in APL.
[AGENT][NEUTRAL] So yes,
[CUSTOMER][NEUTRAL] Have you happen to have the UB of uh your?
[AGENT][NEUTRAL] I'm not showing again so for this [PII] I'm not showing that we have received the claim from this provider for that date of service for that amount, so it looks um or for any from this provider so it looks like this claim needs to be resubmitted to us.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Right
[CUSTOMER][NEUTRAL] OK. May I know the time you're trying to remit the claim?
[AGENT][NEGATIVE] There is no timely filing limit.
[CUSTOMER][NEUTRAL] OK, no.
[CUSTOMER][NEUTRAL] May I know the mailing address pay ID?
[AGENT][NEUTRAL] Mailing address is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And that is in [PII].
[AGENT][NEUTRAL] Zip code is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Got it.
[AGENT][NEUTRAL] OK, and then that payer ID is 60801.
[CUSTOMER][NEUTRAL] Got it.
[AGENT][NEUTRAL] Did you need that fax number as well?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Sure, that fax number is 877.
[AGENT][NEUTRAL] 365.
[AGENT][NEUTRAL] 942 3.
[CUSTOMER][NEUTRAL] OK. May I know that when was the patient affected with the insurance?
[AGENT][NEUTRAL] Uh yes, this policy's effective date was [PII].
[AGENT][NEUTRAL] And it is currently active.
[CUSTOMER][NEUTRAL] OK. [PII], sorry.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Good idea.
[CUSTOMER][NEUTRAL] Yeah, yeah, I got it. Thank you, [PII], for the information and I do have one more data service for the same patient. Would you please like to help me with that?
[AGENT][NEUTRAL] Uh, sure, what was that date of service?
[CUSTOMER][NEUTRAL] It is [PII] for an amount of $394 even.
[AGENT][NEUTRAL] [PII], OK, one moment.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, we've not received that claim either, [PII].
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So we need to resubmit the claim, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] There is no timely flying limit to submit the claim, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] OK. Thank you for the information you've been provided, [PII]. May I have your best conference number?
[AGENT][NEUTRAL] Reference number would be my first name, last initial [PII]'s date. Yeah, so my name is spelled [PII] And was there anything else I could help you with?
[CUSTOMER][POSITIVE] No, [PII]. Have a great day. Bye-bye.
[AGENT][POSITIVE] Of course, thanks for calling APL you too bye bye.
[CUSTOMER][NEUTRAL] Bye bye.