AccountId: 011433970860
ContactId: 37ededa1-6883-41fb-99c9-89a346bfaf26
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 270420 ms
Total Talk Time (AGENT): 89098 ms
Total Talk Time (CUSTOMER): 105477 ms
Interruptions: 0
Overall Sentiment: AGENT=0, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/05/37ededa1-6883-41fb-99c9-89a346bfaf26_20250205T19:27_UTC.wav
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[AGENT][NEUTRAL] Calling APL, this is [PII]. May I assist you?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Hi, this is [PII] from University of Miami to check on a claim status.
[AGENT][NEUTRAL] Sure, [PII], I can assist you with that. Can I have a callback number for you?
[CUSTOMER][NEUTRAL] It's [PII] [PII].
[AGENT][NEUTRAL] And [PII], what is the policy number of the member that you're inquiring claim status for today?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] It's uh 01823358 M as in Mike, L as in Lima, number 8.
[AGENT][NEUTRAL] Could you verify the patient's name and date of birth and I'll be able to assist you.
[CUSTOMER][NEUTRAL] Sure, ma'am. My name is [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] Thank you, [PII]. And what is the date of service?
[CUSTOMER][NEUTRAL] [PII] total bill amount is $299 even.
[AGENT][NEUTRAL] Was it for a facility charge?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] Was it for a facility charge?
[CUSTOMER][NEUTRAL] Yes, $299 even.
[AGENT][NEUTRAL] For facility charge, was it for the facility like an outpatient facility?
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] Uh, uh, um, just a minute, give me a moment.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Actually, Medicare, uh sorry, neighborhood process the claim as primary and they leave with the balance copay $50.
[AGENT][NEUTRAL] OK, so [PII], I'm asking you, was it for a facility charge like it was a outpatient facility charge? because I'm not showing a claim on file for that bill amount.
[CUSTOMER][NEUTRAL] No, it's a telephone.
[AGENT][NEUTRAL] What is your procedure code?
[CUSTOMER][NEUTRAL] It's 99214.
[CUSTOMER][NEUTRAL] $299 even.
[AGENT][NEUTRAL] And what was the bill amount?
[CUSTOMER][NEUTRAL] Alright
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Bear with me while I look it up to see we have this claim on file.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Hey.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] I'm not showing this claim on file, [PII].
[CUSTOMER][NEUTRAL] OK. No on for that.
[AGENT][NEUTRAL] Can you verify where you submitted that claim to?
[CUSTOMER][NEUTRAL] Um, we submitted to the electronic pay ID 60801.
[AGENT][NEUTRAL] So there's no claim on file, you might wanna resubmit the claim.
[CUSTOMER][NEUTRAL] Uh, sure. May I know the member effective date of coverage?
[AGENT][NEUTRAL] Give me one moment.
[CUSTOMER][NEUTRAL] You.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] This policy has been active since [PII] and is currently active.
[CUSTOMER][NEUTRAL] And may I know the correct mailing address?
[AGENT][NEUTRAL] The mailing address will be addressed to APL claims department.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII]. That's [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And the day is uh.
[CUSTOMER][NEUTRAL] May I know the time spending limit?
[AGENT][NEUTRAL] Could you repeat yourself?
[CUSTOMER][NEUTRAL] Family filing limit.
[AGENT][NEGATIVE] There's no timely filing.
[CUSTOMER][NEUTRAL] And the pay is uh 60801, right?
[AGENT][NEUTRAL] Yes, 60801 is the payer ID.
[CUSTOMER][NEUTRAL] Could you please spell your name?
[AGENT][NEUTRAL] [PII]. Is there anything else that I can assist you with today, [PII]?
[CUSTOMER][NEUTRAL] That's all for today. May I know the conference number?
[AGENT][NEUTRAL] We don't provide those. You can use my name and today's date as a reference.
[CUSTOMER][POSITIVE] OK. Thank you so much for your kind assistance and have a great day. Bye-bye.
[AGENT][POSITIVE] Thanks for calling APL. You have a great one as well, [PII]. Goodbye.