AccountId: 011433970860
ContactId: 38798aa5-ba51-46bd-976b-9a3306d90e3e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 351899 ms
Total Talk Time (AGENT): 139337 ms
Total Talk Time (CUSTOMER): 85017 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/05/38798aa5-ba51-46bd-976b-9a3306d90e3e_20250205T21:44_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm calling from the provider office. I need to check on our bill status. Could you please help me with that?
[AGENT][NEUTRAL] OK, you're needing to check a bill or check a claim status?
[CUSTOMER][NEUTRAL] Claim status.
[AGENT][POSITIVE] Yes, ma'am. I can help you with that. And could you spell your name for me?
[CUSTOMER][NEUTRAL] Sure, it's [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And [PII], what is your callback number?
[CUSTOMER][NEUTRAL] [PII]. Extension is [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII]. OK, thank you. And you have one claim that you're needing status on, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes ma'am, I can help you with that. And [PII], what is the member's policy number?
[CUSTOMER][NEUTRAL] I do have the policy number as 02292087.
[AGENT][NEUTRAL] OK, thank you, give me a moment please to get the member's information pulled up.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Could you please spell your name?
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And you will use my name, [PII] along with today's date if you need a call reference number for our call.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK, then I say, any information that I do provide for you today will be a verification of benefits and not a guarantee of payment. What is your patient's name, please, and their date of birth?
[CUSTOMER][NEUTRAL] Patient's name is [PII] with the date of birth [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And what is the data service and total bill amount?
[CUSTOMER][NEUTRAL] [PII] and the total bill amount is $223 even.
[AGENT][POSITIVE] Thank you, one moment.
[AGENT][NEUTRAL] OK, and you said the data service is [PII], is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, there is no claim on file for her for that data service.
[CUSTOMER][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] Uh, there's no claim on file, and can you give me the mailing address to submit the claim?
[AGENT][NEUTRAL] Yes, the claims mailing address would be to IMA.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] The zip code is [PII].
[AGENT][NEUTRAL] And the payer excuse me, the electronic payer ID is 64556.
[CUSTOMER][NEUTRAL] Yeah, the mailing address is IME. It's.
[AGENT][NEUTRAL] Mhm. I M A.
[CUSTOMER][NEUTRAL] [PII] with the payer ID 64556.
[AGENT][POSITIVE] Yes, ma'am, that is correct.
[CUSTOMER][NEUTRAL] Is the case is open or closed, as the member is active for detail service?
[AGENT][NEUTRAL] This policy was active from [PII]. It termed [PII].
[CUSTOMER][NEUTRAL] Is this a worker's compensation?
[AGENT][NEUTRAL] Is our company a workers' compensation company? No, ma'am.
[CUSTOMER][NEUTRAL] No, OK, so it's a commercial insurance, right?
[AGENT][NEUTRAL] This is a, no, we are not a major medical carrier. This is a hospital indemnity limited benefit plan that she had.
[CUSTOMER][NEUTRAL] The family filing to some of the claims.
[AGENT][NEGATIVE] There is no timely filing limit?
[CUSTOMER][POSITIVE] Thank you so much for your assistance. Um you have a great day. Take care and bye-bye.
[AGENT][POSITIVE] Well, I hope you have a great day too. Yes ma'am and thank you. And one last thing if once you all do file a claim with APL, [PII], uh, we do have a portal in which you can also check claim status for us by going to secured. [PII].
[CUSTOMER][POSITIVE] Thank you so much.
[AGENT][POSITIVE] You're very welcome and thank you again for calling APL. I hope you have a nice evening.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye bye.