AccountId: 011433970860
ContactId: 380da027-7139-4450-9115-1537ba7e844b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 331359 ms
Total Talk Time (AGENT): 127960 ms
Total Talk Time (CUSTOMER): 82040 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/16/380da027-7139-4450-9115-1537ba7e844b_20250516T19:32_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] and my insurance is [PII] calling from provider's office to check on the claim status. If you don't mind, could you please spell your name for me?
[AGENT][NEUTRAL] It's [PII]
[AGENT][NEUTRAL] And then I could check that claim for you. uh, [PII], can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes, it is [PII].
[AGENT][NEUTRAL] Thank you. And then do you have the policy number?
[CUSTOMER][NEUTRAL] Uh, give me a moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes, it is 01986724.
[AGENT][NEUTRAL] OK, and what was the name and date of birth for the member?
[CUSTOMER][NEUTRAL] [PII] and date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you for verifying that. What was the date of service for this claim?
[CUSTOMER][NEUTRAL] [PII] with the bill amount $85 even.
[AGENT][NEUTRAL] OK, that was [PII] for $85?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, one moment please.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII], uh, do you have the tax ID for this provider?
[CUSTOMER][NEUTRAL] Yes, it is [PII].
[AGENT][NEUTRAL] OK, so I'm not showing that we received a claim for $85. Um, I do have one for the state of service for $39.87. Is that the amount remaining after major medical paid?
[CUSTOMER][NEUTRAL] OK, you're saying it is no claim on file.
[AGENT][NEUTRAL] Not for this amount. I do have one for $39.87. Was that the amount left over for major medical?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK give me a moment.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][POSITIVE] Uh, thank you so much for waiting. Is it regarding offset?
[AGENT][NEUTRAL] Um, one moment.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, no, it was for a, uh, facility, um.
[AGENT][NEUTRAL] It does not appear that we we have that claim, so that might need to be resent to us.
[CUSTOMER][NEUTRAL] OK, it is no claim on file. Am I right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK. May I know member effective dates?
[AGENT][NEUTRAL] Yes, um, so I will tell you that the first policy number that you gave me, [PII] was an older one that was not active during this state of service, so whenever you're ready I will give you the one that is currently active.
[CUSTOMER][POSITIVE] Sure, I'm ready.
[AGENT][NEUTRAL] OK, that is 0246.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 2790.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you so much. May I know member effective and term dates, please?
[AGENT][NEUTRAL] Yes, so the effective date for this policy is, uh, that was [PII] and it is currently active.
[CUSTOMER][NEUTRAL] OK. May I know payer ID?
[AGENT][NEUTRAL] But it's 60801.
[CUSTOMER][POSITIVE] OK, thank you so much. May I know your mailing address to submit the claim?
[AGENT][NEUTRAL] Yes, that is uh [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And that is in [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mm OK.
[AGENT][NEUTRAL] Zip code is [PII].
[CUSTOMER][NEUTRAL] OK. May I know TFL to submit the claim?
[AGENT][POSITIVE] I'm so sorry, what was that?
[CUSTOMER][NEUTRAL] Timely filing limit to submit the claim.
[AGENT][NEGATIVE] Uh, there is no timely filing limit.
[CUSTOMER][POSITIVE] OK, thank you so much. And I have a few more claims to check. Can you provide the status, please?
[AGENT][NEUTRAL] Are they for the same member?
[CUSTOMER][NEUTRAL] And it is on a different member.
[AGENT][NEUTRAL] Are they for different members?
[AGENT][NEUTRAL] They are OK. Uh, one moment. Sure, one moment, um, I'll let you know when I'm ready for that next policy number. Was there any other information that you needed for this claim?
[CUSTOMER][NEUTRAL] Yes, it is on a different, ma'am.
[CUSTOMER][NEUTRAL] So, thank you. I got a request in for this number.
[AGENT][NEUTRAL] OK, one moment please.
[CUSTOMER][NEUTRAL] Sure.