AccountId: 011433970860
ContactId: 38e2456e-5ba7-49c4-ace0-c136fad48620
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 250970 ms
Total Talk Time (AGENT): 84830 ms
Total Talk Time (CUSTOMER): 91489 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/13/38e2456e-5ba7-49c4-ace0-c136fad48620_20250313T21:18_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. My name is.
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from provider's office, checking on a claim status.
[AGENT][POSITIVE] OK, I'll be more than happy to help you with your claim status, [PII]. May I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure, that's [PII].
[AGENT][NEUTRAL] Thank you for that. And how many claims do you have in total today?
[CUSTOMER][NEUTRAL] One claim?
[AGENT][NEUTRAL] Alright, may I have the member's policy number?
[CUSTOMER][NEUTRAL] 1152749.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Uh the first name [PII] Last name [PII].
[CUSTOMER][NEUTRAL] Date of birth, [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And may I have the date of service for the claim?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the total bills?
[CUSTOMER][NEUTRAL] $47,481 even.
[AGENT][NEUTRAL] And it's [PII]?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK, so I'm actually showing there's no claim on file for that data service.
[CUSTOMER][NEUTRAL] OK. And let me check. So we will the claim through the paper. So let me give you the mailing address that we sent. So it's gonna be [PII].
[CUSTOMER][NEUTRAL] Mr. [PII].
[AGENT][NEUTRAL] No, so the old claims mailing address used to be [PII], but that's old. I can give you the the current claims mailing address.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Uh, OK, sure. That's gonna be [PII].
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, uh [PII].
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] The zip code is [PII].
[CUSTOMER][NEUTRAL] 24. OK. And do you have the policy effective date?
[AGENT][NEUTRAL] Hold on one moment.
[AGENT][NEUTRAL] Policy has been effective since [PII].
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] No, to current, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] And what will be the timely filing?
[AGENT][NEUTRAL] Um, there's no timely filing limit as long as the policy was active on the date of service.
[CUSTOMER][POSITIVE] OK, awesome. Thank you.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And uh the group number 16321, is that correct for the patient?
[AGENT][NEUTRAL] 16312.
[CUSTOMER][NEUTRAL] Mhm. And do you have any group name for that?
[AGENT][POSITIVE] Healthy mothers, healthy babies.
[CUSTOMER][POSITIVE] All right. OK. Thank you so much. Mm. All right. Thank you so much for that. So I'll be submitting the claim again and now can I have the call reference?
[AGENT][NEUTRAL] Sure, so there's no call reference number, but you can use my name in today's date. The first initial of my last name is [PII].
[CUSTOMER][POSITIVE] All right, thank you. OK, thank you so much for helping me and hope you have a great day. Take care. Bye for now.
[AGENT][POSITIVE] Thank you also and thanks for calling APL. Bye-bye.
[CUSTOMER][NEUTRAL] Bye bye.