AccountId: 011433970860
ContactId: 39abb5d8-55a9-47be-b467-e32ecf5bb906
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 221429 ms
Total Talk Time (AGENT): 75346 ms
Total Talk Time (CUSTOMER): 92234 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/21/39abb5d8-55a9-47be-b467-e32ecf5bb906_20250221T16:19_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], I'm just calling to check status of a claim for a patient.
[AGENT][NEUTRAL] OK, I can help you with the claim status. May I have your name and a good contact number?
[CUSTOMER][NEUTRAL] Yes, my name is [PII]. Contact number is [PII].
[AGENT][NEUTRAL] Thank you for that. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] Uh yes sorry one there you go, it is 02006913.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. May I have the date of service for the claim you like me to check on?
[CUSTOMER][NEUTRAL] It is [PII].
[CUSTOMER][NEUTRAL] The amount is 244.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And can you verify the name of the facility um on the claim?
[CUSTOMER][NEUTRAL] Osborne Family Medicine.
[AGENT][NEUTRAL] OK, so I'm not showing a claim on file um for that provider, for that data service or total bill.
[CUSTOMER][NEUTRAL] OK, um.
[CUSTOMER][NEUTRAL] So we did send our claim to IMA at the Egan PO box and I just did talk to them. They said they don't have a claim because they only process the wellness claims to this patient and it would have been processed and forwarded over to APL.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, they suggested that if you guys didn't receive it to resend it to the exact same address that I sent it to, is that what you suggest I do as well?
[AGENT][NEUTRAL] Yes, you can only send this type of policy to IMA and they'll um process it, reprice it if they can. If not, they'll go ahead and send it to us for processing.
[CUSTOMER][NEUTRAL] OK, so just go ahead and resend that one, and then the next thing, uh, go ahead, sorry.
[AGENT][NEUTRAL] They also
[AGENT][NEUTRAL] They also have a payer ID if you'd like.
[CUSTOMER][NEUTRAL] Uh, sure.
[AGENT][NEUTRAL] So it's 64556.
[CUSTOMER][NEUTRAL] 56. OK, I believe we might have tried to send it electronically, but for some reason it like rejects for really weird reasons like address and issues like that.
[AGENT][NEUTRAL] Mm, OK.
[CUSTOMER][NEUTRAL] But we can try um I know it's odd and then um.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Do you show that his plan also turned on [PII]?
[AGENT][NEUTRAL] Let's see, hold on one moment.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] Yes, it turned on [PII].
[CUSTOMER][POSITIVE] Awesome thank you and I get I'll just resend the claim. Uh, can I get a reference number please?
[AGENT][NEUTRAL] Sure, so there's no call reference number, but you can use my name in today's date. So again, that's [PII], first initial to my last name is [PII], and then today's date.
[CUSTOMER][POSITIVE] OK, got you, thank you, have a good weekend.
[AGENT][POSITIVE] You also, and thanks for calling APL. Bye-bye.
[CUSTOMER][POSITIVE] Thank you. Bye-bye.