AccountId: 011433970860
ContactId: 42ba5496-e5d7-40cd-b5ba-fd28d8e6482d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 293260 ms
Total Talk Time (AGENT): 94894 ms
Total Talk Time (CUSTOMER): 143375 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/10/42ba5496-e5d7-40cd-b5ba-fd28d8e6482d_20250610T19:40_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yes, [PII], good afternoon. By the way, my first name is [PII] and my last name initial is [PII], and I am calling from La core billing department. This line may be recorded for quality and training purposes, and I am calling about for the claim status of one payment more patient. Would you please help me with this?
[AGENT][POSITIVE] Yes, I'll be more than happy to help you with the claim status and just for my notes, can you spell your first name for me please and provide a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure. It is [PII], and our callback number it is [PII].
[AGENT][NEUTRAL] Thank you for that. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] Sure. It is 02465240.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] First name is [PII], last name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment and
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, may I have the date of service and the total bill for the claim?
[CUSTOMER][NEUTRAL] Sure, it is on [PII] with the amount of $539.70.
[AGENT][NEUTRAL] And that was [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] So I'm not showing a claim on file for [PII] for [PII].
[AGENT][NEUTRAL] I'm actually, Shawn, we haven't.
[CUSTOMER][NEUTRAL] It doesn't reflected on your end?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] It doesn't reflect it on your end, is that right?
[AGENT][NEUTRAL] Right, there's no claim on file. We have not yet processed a claim for [PII].
[CUSTOMER][NEUTRAL] OK, I see. But there is a patient name reflected on your end, is that right?
[AGENT][NEUTRAL] Yes, she's a, she's a, she's covered on the policy. We just haven't received the claim.
[CUSTOMER][NEUTRAL] OK, I see. So since it doesn't reflected the claim for this patient, are we going to resubmit on your end about the correct the claim for this patient?
[AGENT][NEUTRAL] Uh, well, say that one more time. So it's not a corrected claim, you'll just be resubmitting the claim because we never received it.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, uh, may I know the mailing address where we should send this?
[AGENT][NEUTRAL] Yes, it's [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the zip code is [PII].
[CUSTOMER][NEUTRAL] OK, is it right just just to confirm if the mailing address is correct what I'm, it is [PII] [PII] and the state is [PII]. Zip code is [PII].
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] OK, and also do you have the payer ID?
[AGENT][NEUTRAL] Yes, our payer ID is 60801.
[CUSTOMER][NEUTRAL] OK, and may I know the timely filing for sending this?
[AGENT][NEGATIVE] Um, there's no timely filing as long as the policy was active on the data service.
[CUSTOMER][POSITIVE] OK, I see. Thank you so much for that and based on your end this claim is active, is that right?
[AGENT][NEUTRAL] Um, let me check the effective date. Hold on one moment.
[CUSTOMER][NEUTRAL] This insurance?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, so this policy is active, it's been effective since [PII].
[CUSTOMER][NEUTRAL] And there is no termination date on your end, is that right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] OK, I see. Thank you so much for confirming about this, and that is all the information I needed about this one. We're going to resubmit this, um, claim on your end just due process about the claim status for this patient. Thank you so much. May I know the reference number for this call, please?
[AGENT][NEUTRAL] There's no call reference number, but you can use my name in today's date. The first initial to my last name is [PII].
[CUSTOMER][NEUTRAL] Oh,
[CUSTOMER][POSITIVE] OK, I see. Thank you so much, [PII], for assisting me about this one. I really appreciate that and also I don't take too much of your time. Have a great day, [PII].
[AGENT][POSITIVE] You also, and thanks for calling APL. Bye-bye.
[CUSTOMER][NEUTRAL] Bye.