AccountId: 011433970860
ContactId: 3a048b4e-e08e-4488-8237-521bd6a136a5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 474779 ms
Total Talk Time (AGENT): 95611 ms
Total Talk Time (CUSTOMER): 112847 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/11/3a048b4e-e08e-4488-8237-521bd6a136a5_20250611T18:57_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes, hi [PII]. My first name is [PII]. My last name is [PII] calling you from the provider's office looking for claim status.
[AGENT][NEUTRAL] OK, [PII], I can help you with claim status. Do you have a good callback number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. And you have the policy number of the patient?
[CUSTOMER][NEUTRAL] Yes, 02137698.
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] First name is [PII]. Last name is [PII]. Date of birth is [PII]. I mean, date of birth is [PII].
[AGENT][NEUTRAL] And date of service and bill charges?
[CUSTOMER][NEUTRAL] 36 2024 total charge is $1,484 even.
[AGENT][NEUTRAL] OK, give me just a moment.
[AGENT][NEUTRAL] Well, I, I see a claim that's for um a lot less than that for date of service [PII], is that right?
[CUSTOMER][NEUTRAL] Uh, data services 3624.
[AGENT][NEUTRAL] You know what
[AGENT][NEUTRAL] Do you know what the codes were on the claim?
[CUSTOMER][NEUTRAL] Yeah, the CBD codes just.
[CUSTOMER][NEUTRAL] I have the diagnosis code.
[AGENT][NEUTRAL] You have the procedure code?
[CUSTOMER][POSITIVE] Uh, that is good.
[CUSTOMER][NEUTRAL] Let me also recheck here.
[CUSTOMER][NEUTRAL] Uh, actually, I don't have.
[AGENT][NEUTRAL] who is the provider?
[CUSTOMER][NEUTRAL] Uh, let me.
[CUSTOMER][NEUTRAL] This is San Francisco Medical Center.
[AGENT][NEUTRAL] Looks like we don't have the claim on file. I don't have any facility charges on file.
[AGENT][NEUTRAL] Um, can you resubmit?
[CUSTOMER][NEUTRAL] OK. Can I, can I have the member's effective date?
[AGENT][NEUTRAL] Effective date [PII].
[CUSTOMER][NEUTRAL] At the time they found the name.
[AGENT][NEUTRAL] There's no time like filing limit.
[CUSTOMER][NEUTRAL] Thank you. Let's, uh, move to the next pages. I have just one more claims.
[AGENT][NEUTRAL] Wait, one moment.
[AGENT][NEUTRAL] And the policy number?
[CUSTOMER][NEUTRAL] OK, the patient's ID is.
[CUSTOMER][NEUTRAL] 021-73249.
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] First name is uh [PII] Last name is [PII].
[AGENT][NEUTRAL] Date of service and bill charges.
[CUSTOMER][NEUTRAL] [PII] total charge is $7,386 even.
[AGENT][NEUTRAL] Uh, you say 7,386, is that right?
[CUSTOMER][NEUTRAL] 0386 yes.
[AGENT][NEUTRAL] It looks like we received the claim on 5-9-2025.
[AGENT][NEUTRAL] Oh that's 512, 2025.
[AGENT][NEUTRAL] You made a payment of 63293, single check.
[CUSTOMER][NEUTRAL] OK, check number.
[AGENT][NEUTRAL] 2,043,890.
[CUSTOMER][NEUTRAL] 304-3890, right?
[AGENT][NEUTRAL] 2,043,890.
[CUSTOMER][NEUTRAL] OK. And the issue date?
[AGENT][NEUTRAL] Issue date was [PII].
[CUSTOMER][NEUTRAL] And the uh clear date.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And the pay to address.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And the claim number?
[AGENT][NEUTRAL] My number is
[AGENT][NEUTRAL] 3600023
[CUSTOMER][NEUTRAL] OK, uh, can you please, uh, fax me the EOB.
[AGENT][NEUTRAL] Your fax number?
[CUSTOMER][NEUTRAL] The fax number is [PII].
[AGENT][POSITIVE] OK, I'll get that faxed over. It just takes a few minutes. And anything else I can help with?
[CUSTOMER][NEUTRAL] Uh, no thank you, and, uh, can I have the call reference number?
[AGENT][NEUTRAL] That's my name, [PII], and today's date.
[CUSTOMER][POSITIVE] OK. Thank you. That's all I need to have a very blessed day.
[AGENT][POSITIVE] OK, thank you for calling APLU as well. Bye bye.