AccountId: 011433970860
ContactId: 3e8fb287-e601-4250-9db5-f768c4f0a479
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1104089 ms
Total Talk Time (AGENT): 291649 ms
Total Talk Time (CUSTOMER): 389810 ms
Interruptions: 1
Overall Sentiment: AGENT=0.8, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/11/3e8fb287-e601-4250-9db5-f768c4f0a479_20250211T15:22_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]. This is [PII] calling from the doctor's office.
[AGENT][POSITIVE] Good morning, [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yeah, I just need to check, uh, are there any claims on file for the member?
[AGENT][POSITIVE] It would be my pleasure to assist you, [PII]. What is the callback number?
[CUSTOMER][NEUTRAL] Yeah, it's [PII]. Could you spell out your name?
[AGENT][NEUTRAL] It's [PII] and the first initial and my last name is [PII].
[CUSTOMER][NEUTRAL] Yeah, sure.
[AGENT][NEUTRAL] Thank you, [PII]. And what is the policy number for the patient, please?
[CUSTOMER][NEUTRAL] Yeah, the policy number is
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] 994,160.
[AGENT][NEUTRAL] Thank you, [PII]. And what is the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] Yeah, it's uh [PII].
[CUSTOMER][NEUTRAL] And the date of birth is [PII].
[AGENT][NEUTRAL] Alright, thank you, [PII], and I can help you with that claim status. What is the date of service please?
[CUSTOMER][NEUTRAL] Yeah, the date of services.
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] I am checking [PII]'s policy for [PII]. I do not have a claim on file for [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It can be faxed directly to our claims department with the primary EOB.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Would you like our fax number?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] The fax number to our claims department is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] It's [PII], right?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] Uh, need to fax claim form along with primary, right?
[AGENT][POSITIVE] Yes, sir, that's correct.
[CUSTOMER][NEUTRAL] Sure. Thank you. Uh, and the timely filing limit is?
[AGENT][NEUTRAL] No termly filing.
[CUSTOMER][NEUTRAL] OK. Uh, active date of services for the member?
[AGENT][NEUTRAL] Um, yes, the effective date is [PII], and the policy is active.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And activity date.
[AGENT][NEUTRAL] Hm
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] Let's move on to the next claim, [PII].
[AGENT][NEUTRAL] Alright, bear with me just one second.
[CUSTOMER][NEUTRAL] I
[AGENT][POSITIVE] All right, I'm ready, [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] It's the member ID is 2467742.
[AGENT][NEUTRAL] And that name and date of birth?
[CUSTOMER][NEUTRAL] It's uh
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, [PII] and what is that data service?
[CUSTOMER][NEUTRAL] Yeah, the date of service is [PII].
[AGENT][NEUTRAL] And what is the bill amount please sir?
[CUSTOMER][NEUTRAL] Yeah. The bill amount is $27 even.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] I'm checking that claim for you.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Claim was received on [PII].
[AGENT][NEUTRAL] I'm sorry, [PII]. I apologize.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And processed on [PII].
[AGENT][NEUTRAL] And there was a payment of $14.84 I'm sorry, $14.85 sent to South Florida ENT Associates.
[CUSTOMER][NEUTRAL] OK. Uh, the payment was made via?
[AGENT][NEUTRAL] Single paper check.
[CUSTOMER][NEUTRAL] Single paper check.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] The pay to addresses?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Uh, could you repeat it again? Sorry.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] Uh, it is a bulk or in a single amount?
[AGENT][NEUTRAL] Single.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Issued on
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Check number?
[AGENT][NEUTRAL] 2,014,600
[CUSTOMER][NEUTRAL] OK. Uh, could I get the
[CUSTOMER][NEUTRAL] Deposit cash?
[AGENT][NEUTRAL] Cleared on [PII].
[CUSTOMER][NEUTRAL] OK. The claim number would be?
[AGENT][NEUTRAL] 353.
[AGENT][NEUTRAL] 1863.
[CUSTOMER][POSITIVE] Perfect. Could I get a fax of EOB?
[AGENT][NEUTRAL] EOBs are obtainable on our provider portal at secured.
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII]. It's a simple self-registration site.
[CUSTOMER][NEUTRAL] Just a sec. Let me just check.
[CUSTOMER][NEUTRAL] Could I get the patient account number?
[AGENT][NEUTRAL] Patient account number is [PII] [PII].
[CUSTOMER][NEUTRAL] Uh, it is showing that no user was found with the information that was entered.
[AGENT][NEUTRAL] Did you enter the tax ID number?
[CUSTOMER][NEUTRAL] Yeah, it's, it is [PII].
[AGENT][NEUTRAL] Mhm. And did you create an account?
[CUSTOMER][NEGATIVE] Now, I'm trying to create a one, but I couldn't.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me fax it to you. I think there are some issues with the server. Hang on just a second.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Do you need my fax number?
[AGENT][NEUTRAL] Yeah, bear with me just one moment, [PII]. Let me get that prepared.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][POSITIVE] Sure. Thank you.
[AGENT][NEUTRAL] And can I put this to your attention?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] OK, give me just a moment and once I get this prepared, I'll get that fax number and go ahead and send it for you.
[CUSTOMER][POSITIVE] Sure. Thank you.
[AGENT][NEUTRAL] All right, [PII], what's that fax number please?
[CUSTOMER][NEUTRAL] Yeah, the fax number is [PII].
[AGENT][NEUTRAL] And just to verify that fax number I'm sending this to [PII].
[CUSTOMER][NEUTRAL] Yeah. Oh no, it's
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, bear with me.
[CUSTOMER][NEUTRAL] Because I.
[AGENT][POSITIVE] All right, [PII], that's on the way for you.
[CUSTOMER][POSITIVE] Yeah, thank you.
[AGENT][POSITIVE] It's been a pleasure to help you with that claim status. Anything else I can help you with today?
[CUSTOMER][NEUTRAL] The call reference number for this claim would be?
[AGENT][NEUTRAL] My name in today's date.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Um
[AGENT][POSITIVE] That's right.
[CUSTOMER][NEUTRAL] Alright, thank you. Just a sec, let me
[CUSTOMER][NEUTRAL] Just check on the plane.
[CUSTOMER][NEUTRAL] It is OK, right?
[AGENT][NEUTRAL] I'm sorry.
[CUSTOMER][NEUTRAL] Uh, let's go to the next claim. Is it OK?
[AGENT][NEUTRAL] Yeah, what's that policy number?
[CUSTOMER][NEUTRAL] Yeah, it's 1019544477.
[CUSTOMER][NEUTRAL] 4 M as in Mike, L as in Lima, 8.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Do you mind repeating that number please, sir?
[CUSTOMER][NEUTRAL] Sure. It's 019.
[CUSTOMER][NEUTRAL] 547 7.
[CUSTOMER][NEUTRAL] Number 4, M as in Mike, L as in Lima.
[CUSTOMER][NEUTRAL] Number 8.
[AGENT][NEUTRAL] Thank you, [PII]. And what is that name and date of birth?
[CUSTOMER][NEUTRAL] Yeah, the name is.
[CUSTOMER][NEUTRAL] [PII]. And the date of birth is [PII].
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] All right, thank you. And what is that data service?
[CUSTOMER][NEUTRAL] Yeah, the date of service is 5-15-24.
[CUSTOMER][NEUTRAL] With the bill amount of $303 even.
[AGENT][NEUTRAL] 5 1524. I do not have a claim on file.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Uh, what is the difference between sending a claim via fax and, uh, electronically? Will that make a difference?
[AGENT][NEUTRAL] It would not make a difference. Now we will need the primary EOB for that data for that claim as well.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Instead of uh going around, it would make you easier to adjudicate the claim, right?
[AGENT][NEUTRAL] That's right. We will need the primary EOB as well as the claim form.
[CUSTOMER][NEUTRAL] Sure. Uh, just a sec.
[CUSTOMER][NEUTRAL] No is active from?
[AGENT][NEUTRAL] 101 2020 to 101 2024.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] I'll fax it over. Um, I'll just check if there are any other claims.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Let us go with the next member ID. It's 0248.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 7672 M as in Mike, [PII] as in [PII], 8.
[AGENT][NEUTRAL] Name and date of birth?
[CUSTOMER][NEUTRAL] Yeah, the name and the date of birth is [PII].
[AGENT][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] And the date of birth is [PII].
[AGENT][NEUTRAL] Data service.
[CUSTOMER][NEUTRAL] It is 5:20 24.
[AGENT][NEUTRAL] 52024 no claim on file.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Same information. Mhm um.
[CUSTOMER][NEUTRAL] And the active date, sir?
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Active date is [PII] and policy termed on [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And uh
[CUSTOMER][NEUTRAL] L
[AGENT][NEUTRAL] I'm sorry.
[CUSTOMER][NEUTRAL] Uh, the term date is?
[AGENT][NEUTRAL] [PII], I'm sorry, [PII].
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Um, just a sec.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, I do have 2 more claims here.
[AGENT][NEUTRAL] OK, I can do 2 more. What's, what's the next policy number? You're welcome.
[CUSTOMER][POSITIVE] Thank you. Yeah. Thank you, [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] It is.
[CUSTOMER][NEUTRAL] 000.
[CUSTOMER][NEUTRAL] C as in Charlie, 100.
[CUSTOMER][NEUTRAL] 280
[AGENT][NEUTRAL] [PII]
[AGENT][NEGATIVE] [PII], I hate to interrupt. That's not our policy number.
[CUSTOMER][NEUTRAL] Oh, sorry, just a sec. Let me just check once.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] You.
[CUSTOMER][NEUTRAL] Hey, you know.
[CUSTOMER][NEUTRAL] That. That is OK.
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] It's just.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Hello, uh, does American Republic of come under your insurance?
[AGENT][NEUTRAL] APL, yes, sir. American Public Life.
[CUSTOMER][NEUTRAL] No, it's
[CUSTOMER][NEUTRAL] No, it's uh American Republic Corporation Insurance Company.
[AGENT][NEUTRAL] That's not us.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] No we can.
[CUSTOMER][POSITIVE] Thank you. Let's move the last one then.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] The member ID is 02298029.
[AGENT][NEUTRAL] Patient's name and date of birth.
[CUSTOMER][NEUTRAL] Yeah, the patient's name is [PII].
[CUSTOMER][NEUTRAL] And the date of birth is [PII].
[AGENT][NEUTRAL] Excuse me, and data service.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yeah, the date of services.
[CUSTOMER][NEUTRAL] [PII] with the amount of $102 even.
[AGENT][NEUTRAL] For Ruth data service 71524 no claim on file.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And uh
[CUSTOMER][NEUTRAL] Active data of services.
[AGENT][NEUTRAL] [PII] and the policy is current.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][POSITIVE] Perfect, [PII].
[CUSTOMER][POSITIVE] Thank you. Thank you for the help. Wish you a great day.
[AGENT][POSITIVE] It's been my pleasure to assist you. I hope you have a great day as well, [PII]. Thank you for calling APL. Bye-bye.
[CUSTOMER][POSITIVE] Yeah, bye. Thank you, bye.
[AGENT][NEUTRAL] Bye-bye.