AccountId: 011433970860
ContactId: 390724af-61fc-4f41-b660-729f542f3ee6
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 515058 ms
Total Talk Time (AGENT): 203916 ms
Total Talk Time (CUSTOMER): 216596 ms
Interruptions: 3
Overall Sentiment: AGENT=0.1, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/14/390724af-61fc-4f41-b660-729f542f3ee6_20250514T17:45_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, how are you doing? My name is [PII]. I'm calling from the provider. I just had a question in reference to, uh, it's my first time submitting claims to you guys, and I was just trying to get basic information as far as, uh, uh, if you guys like deal with HMO or commercial or PPO and timely filing payer ID all that basic stuff.
[AGENT][NEUTRAL] OK, is it for a specific patient?
[CUSTOMER][NEUTRAL] Uh, well, I had a patient, um, I'm not sure if we're billing them or not, but it's just in general because I guess they want to start sending patients to us and I was just trying to get whatever basic information so I don't have to end up billing patients if they're out of network or if we're out of network. I'm not sure.
[AGENT][NEUTRAL] OK, it will, it will depend on the policy. We have a lot of policies. We are not major medical though.
[AGENT][NEUTRAL] Um, it just depends on what kind of policy you're wanting to know about.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] You can submit claims with us through an online portal at [PII]. I don't know if that would help.
[CUSTOMER][NEUTRAL] Um, so I.
[CUSTOMER][NEUTRAL] They gave me a payer ID 60801.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] But I don't know. That's what I was given by the doctor's office, um, and on there I just, I was trying to figure out what was timely filing if this is commercial or uh if you guys deal with Medicaid and Medicare patients or just employer.
[AGENT][NEUTRAL] It is typically through their employer. Now there are instances where they can have other medical or they can have Medicaid. Um, it just depends on their status that payer ID is correct.
[CUSTOMER][NEUTRAL] CPR
[AGENT][NEGATIVE] Um, and we do not have timely filing.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No time to fine.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] As far as, uh, do you guys accept faxes for, for as well for claims as well or no?
[AGENT][NEUTRAL] Do we accept what? I'm sorry.
[CUSTOMER][NEUTRAL] Do you accept, do you accept the claim to be faxed over to you guys, or it has to be only electronically or through paper?
[AGENT][NEUTRAL] Oh no, you can do it either way you can fax them, mail them or you can go through that online portal that I mentioned earlier and upload them through there as well.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] If you go to [PII], it should have a lot of the questions I think you're wanting answered too, but you're more than welcome to call if there's a specific policy um because we do have so many, uh, it just depends on what you're calling for, but we do have a lot of different policies.
[CUSTOMER][POSITIVE] Awesome, OK, uh.
[CUSTOMER][NEUTRAL] Let me let me see if I can pull up the one patient the doctor called me for because I'm not even sure if they have you. They just gave me your information telling me that the patient is gonna have you or something. Uh, let's see what I find.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] So I have an account number here.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, I have the patient, um.
[AGENT][NEUTRAL] And real quick before we get disconnected, can I in case we get disconnected, can I get a callback number?
[CUSTOMER][NEUTRAL] I find that.
[CUSTOMER][NEUTRAL] Yup. It's [PII].
[AGENT][NEUTRAL] And what's the policy number?
[CUSTOMER][NEUTRAL] I have 02571317.
[AGENT][NEUTRAL] Let me look that up for you real quick.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] Do you have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Uh, [PII], [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] It looks like [PII] does have a policy with us. It is this specific policy is a hospital indemnity policy.
[AGENT][NEUTRAL] With the effective date.
[AGENT][NEUTRAL] Being [PII].
[AGENT][NEUTRAL] And it looks like the policy lapsed.
[AGENT][NEUTRAL] On the [PII].
[CUSTOMER][NEUTRAL] So as of [PII] as of [PII] onwards, no more active with you guys?
[AGENT][NEUTRAL] Correct. Now we do not have timely filing so if there was any claims in between that time period or afterwards you may submit it.
[CUSTOMER][NEUTRAL] Ah, OK, so.
[AGENT][NEUTRAL] And you can submit it through fax, email, or or fax sorry, go ahead.
[CUSTOMER][NEUTRAL] February.
[CUSTOMER][NEUTRAL] Sorry, uh, I only have two dates, [PII], so that one should be under that scroll, and the other one is [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] That one, that one probably will get the nice.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Uh-huh, and the other one is [PII].
[AGENT][NEUTRAL] Oh
[CUSTOMER][NEGATIVE] So if I know [PII] is not active with you guys and I can't even bother building it.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Let me check on that first one for you first.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] What was the total bill amount for the one on [PII]?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Oh, a big large amount. Oh, it looks like it was broken up into 123456 small claims for that same data service. They all have different amounts. I'll give you one of them. One of them is like $468.12.
[AGENT][NEUTRAL] OK, give me 1 2nd.
[CUSTOMER][NEUTRAL] OK, hold on one second. We have submitted it to American Workers Insurance Service, so that's what they told us to. But then I spoke to doctor also and I think that this is
[CUSTOMER][NEUTRAL] You guys are the correct here?
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] That could be their their primary interns. Let me check with that real quick. Let me check on that first one.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] And what is the provider's name?
[AGENT][NEUTRAL] For the facility name.
[CUSTOMER][NEUTRAL] Acura
[CUSTOMER][NEUTRAL] Accu Reference Medical lab.
[AGENT][NEUTRAL] OK, yeah, I'm not showing any.
[AGENT][NEUTRAL] Claim for that.
[AGENT][NEUTRAL] Let me double check.
[CUSTOMER][POSITIVE] Yeah, that's why I wanted to build it to, yeah.
[AGENT][NEUTRAL] And you're wanting to file, so also if you go to [PII], there are claim forms available too, or you should have your own.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Yeah, we have it's all electronic. That's why I was making sure I get the payer ID and all that to put it in the system and then just send it out to my caring house.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, because I'm not seeing one for that date of service.
[CUSTOMER][NEUTRAL] OK, yeah, that's because we never billed it to you this other company and that's.
[AGENT][NEUTRAL] And then
[AGENT][NEUTRAL] OK, OK.
[AGENT][NEUTRAL] Yes, we do have, he does, [PII] does have a policy with us, so you can build that um through, you can go through fax, you can mail it or you can um.
[CUSTOMER][NEUTRAL] That
[AGENT][NEUTRAL] Like I said, create an uh an account online at [PII] where you can submit everything electronically and you can even view claim status.
[CUSTOMER][NEUTRAL] Got it. OK, um, can I have your fax number?
[AGENT][NEUTRAL] Our fax number is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Awesome. Thank you so much for your help and time.
[AGENT][POSITIVE] Alright, thank you so much. And is there anything else I can help you with?
[CUSTOMER][NEUTRAL] Uh, the name, the name on the claim, it should be made out to who? APL claims or?
[CUSTOMER][NEUTRAL] Uh, another.
[AGENT][NEUTRAL] American Public Life.
[CUSTOMER][NEUTRAL] It should be, it should be labeled American Public Life, right?
[AGENT][NEUTRAL] Mhm yes sir and you can also go online and it'll have all of that information that I gave you today as well should you decide to mail it um or fax it, all of that information is there as well.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, I'll check it out. Thank you.
[AGENT][POSITIVE] Alright thank you so much thank you for calling.