AccountId: 011433970860
ContactId: 374b99ed-de71-48eb-9a7d-68f989551fdf
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 348019 ms
Total Talk Time (AGENT): 133845 ms
Total Talk Time (CUSTOMER): 121346 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/09/374b99ed-de71-48eb-9a7d-68f989551fdf_20250409T13:00_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII], my name is [PII]. I am uh
[CUSTOMER][NEUTRAL] I'm calling as a provider for a patient. I wanted to see.
[CUSTOMER][NEUTRAL] Basically I can't see on my end if um APL receives their claims um there's no payment or denial so I wanted to check if um this per person first had active coverage through you guys.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Oh, I can definitely help you with the policy and the claim. And [PII], may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes ma'am, it's [PII].
[AGENT][NEUTRAL] Thank you for that. And may I have your policy number?
[CUSTOMER][NEUTRAL] 025
[CUSTOMER][NEUTRAL] 531.
[CUSTOMER][NEUTRAL] 45
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] And I have you here. I just need you to verify your date of birth, your mailing and email address on file or the members, I'm sorry.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] No, you're good. Date of birth is [PII].
[AGENT][NEUTRAL] And actually the, the address and email address, I don't need, just the date of birth is fine. You already um and his first and last name.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] Alrighty, and thank you so much for verifying. And all the information provided is a verification of benefits, not a guarantee of payment. So this policy is active. It's been effective since [PII].
[CUSTOMER][POSITIVE] Cool.
[AGENT][NEUTRAL] And did you want me to search for a data service to see if the claim was on file?
[CUSTOMER][NEUTRAL] Yeah, if we could now that we know that they're enrolled with you guys, if we could check um [PII].
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEGATIVE] There should be 2 claims on that day.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Well, there should be more than 2 claims, but for now let's just do um 2.
[AGENT][NEUTRAL] And what is the name of your provider's office?
[CUSTOMER][NEUTRAL] Uh, West Virginia University Medical Corporation.
[AGENT][NEUTRAL] OK, so,
[AGENT][NEUTRAL] Hold on one moment. I don't see 2 though, let me see.
[AGENT][NEUTRAL] And what's the total bills?
[CUSTOMER][NEUTRAL] Both of the claims should have um 4270 $427.50.
[AGENT][NEUTRAL] What's your tax ID?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, so there is a claim on file.
[AGENT][NEUTRAL] It is, uh, it says WVU Hospitals, but it's a different tax ID and a different total bill.
[CUSTOMER][NEUTRAL] Yeah, yeah.
[CUSTOMER][NEUTRAL] OK, so is it.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] So you don't have any claims on this data service for $427.50?
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] And it's just this one claim for the data service. um, let me try let me.
[CUSTOMER][NEUTRAL] OK, um,
[AGENT][NEGATIVE] But I mean, I'm gonna go back.
[CUSTOMER][NEUTRAL] That's OK. You might not have received it.
[CUSTOMER][NEUTRAL] Let's see.
[AGENT][NEUTRAL] Yeah, this is different.
[AGENT][NEUTRAL] I just wanted to see because it's like two lines on here, so I wanted to make sure it wasn't two separate claims, but no, this is the same claim number.
[AGENT][NEUTRAL] And the same um total bills.
[AGENT][NEUTRAL] OK, so we don't have your claim on file, but there's no timely filing, so you can resubmit it if you like.
[CUSTOMER][NEUTRAL] OK, and you guys do accept claims electronically, right?
[AGENT][NEUTRAL] Yes, and I can give you a payer ID if you need it uh the fax number.
[CUSTOMER][NEUTRAL] Yeah, what's the payer ID?
[AGENT][NEUTRAL] So 60801.
[CUSTOMER][NEUTRAL] And then uh you also said there was a fax number too.
[AGENT][NEUTRAL] Mhm. Our fax number is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] 942 [PII].
[CUSTOMER][POSITIVE] Perfect.
[AGENT][NEUTRAL] We have a mailing address also if you need it.
[CUSTOMER][POSITIVE] Alright perfect and.
[CUSTOMER][NEUTRAL] Uh, is it, uh, [PII]?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Mhm. That's it.
[CUSTOMER][NEUTRAL] And then that's [PII].
[AGENT][POSITIVE] Yeah, you got it.
[CUSTOMER][POSITIVE] Uh, for the zip code, OK, perfect. Alright, that is great. If I can get a reference number, that is all I need today, ma'am.
[AGENT][NEUTRAL] Sure, so there's no call reference number, but you can use my name in today's date, and again, that's [PII].
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][POSITIVE] Thank you so much for your help, ma'am you have a good day.
[AGENT][POSITIVE] Thank you, [PII]. You also, and thanks for calling APL. Bye-bye.
[CUSTOMER][NEUTRAL] Yep bye.