AccountId: 011433970860
ContactId: 432a65b0-81e4-43c4-90cc-1d25b1f0cbba
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 610679 ms
Total Talk Time (AGENT): 136203 ms
Total Talk Time (CUSTOMER): 161049 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/13/432a65b0-81e4-43c4-90cc-1d25b1f0cbba_20250213T16:28_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. This is [PII] calling from Pro office to check on the claim status.
[AGENT][NEUTRAL] OK, I can help you with claim status. Can I get your name again please?
[CUSTOMER][NEUTRAL] Yes, my first name is [PII].
[AGENT][NEUTRAL] OK, Miss [PII], what is your callback number?
[CUSTOMER][NEUTRAL] Yeah, my callback number is [PII].
[AGENT][NEUTRAL] Thank you. And then what's the patient's name?
[CUSTOMER][NEUTRAL] Yeah. The patient name is [PII].
[AGENT][NEUTRAL] And what is Juliet's date of birth?
[CUSTOMER][NEUTRAL] Yeah, the date of birth is [PII].
[AGENT][NEUTRAL] And the policy number, please?
[CUSTOMER][NEUTRAL] Yeah, sure. The policy number is.
[CUSTOMER][NEUTRAL] 02433267
[AGENT][NEUTRAL] OK, let me look her up.
[AGENT][NEUTRAL] OK, and what is the date of service?
[CUSTOMER][NEUTRAL] Yeah. The date of service is [PII] and the bill amount is $437.51.
[AGENT][NEUTRAL] Thank you and then what is the charge amount after the primary insurance paid their part?
[CUSTOMER][NEUTRAL] Yes, give a moment please.
[CUSTOMER][NEUTRAL] Hm
[CUSTOMER][NEUTRAL] That is
[CUSTOMER][NEUTRAL] 2 $29.54.
[AGENT][NEUTRAL] Thank you and then what is the name of the facility you're calling from Miss um [PII]?
[CUSTOMER][NEUTRAL] Yeah, sure. The facility name is North Atlanta Primary Care.
[AGENT][NEUTRAL] OK, I'm gonna put you on a brief hold while I look up this claim for you and I will be right back.
[CUSTOMER][POSITIVE] OK, sure. Please take your time.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] 355.
[AGENT][NEUTRAL] 3555.
[AGENT][NEUTRAL] 40.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Thank you for holding for me [PII]. So looking on data service of [PII], I do not find a claim on file in that facility.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] You mean you did not find any claim on that data service?
[AGENT][NEUTRAL] I did but it wasn't under that facility name.
[CUSTOMER][POSITIVE] OK, thank you so much. May I know the policy effective and terminated for this patient, please.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] The effective date is [PII].
[AGENT][NEUTRAL] And the policy is still active.
[CUSTOMER][POSITIVE] Yes, thank you so much for that information. May I know the time filing limit to submit the claim, please?
[AGENT][NEUTRAL] We do not have one.
[CUSTOMER][NEUTRAL] OK. Thank you so much for that information. May I know the mailing address, please, to submit the claim?
[AGENT][NEUTRAL] Yes, you'll send it to APL claims.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] That's in [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And the zip code is [PII].
[CUSTOMER][NEUTRAL] That is [PII]. And the ZIP code is [PII], right?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][POSITIVE] Thank you so much for that information.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] I have one more claims, but you mentioned that this uh this claim you not received, right? The state of service or this facility?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] The facility
[CUSTOMER][POSITIVE] Yes, thank you so much for that information. May I know the payer ID please to submit the claim?
[AGENT][NEUTRAL] Yes, it's 60801.
[CUSTOMER][NEUTRAL] 6001 it's a four digit number?
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] No, 60801.
[CUSTOMER][NEUTRAL] 60801, right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] Yes, thank you so much for that information.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] I have one more plan. Could you please ask the that answer?
[AGENT][NEUTRAL] Is it for the same member?
[CUSTOMER][NEUTRAL] Yes, same number.
[AGENT][NEUTRAL] OK, what is the date of service?
[CUSTOMER][NEUTRAL] Is the data services.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And the bill amount is 230, yes, go ahead.
[AGENT][NEUTRAL] 8
[AGENT][NEUTRAL] I'm sorry, can you repeat that data service one more time for me?
[CUSTOMER][NEUTRAL] Yeah, sure. That is 828 of 2024.
[AGENT][NEUTRAL] OK, and then what was the bill amount?
[CUSTOMER][NEUTRAL] $277 even.
[AGENT][NEUTRAL] OK and then the charges after primary pay their part?
[CUSTOMER][NEUTRAL] Yes, that is $273.19.
[AGENT][NEUTRAL] OK, and then what is the facility name?
[CUSTOMER][NEUTRAL] Yes, the facility name is
[CUSTOMER][NEUTRAL] North Atlanta Primary Care.
[AGENT][NEUTRAL] OK, I'm gonna put you on hold while I look up this claim for you. I'll be right back.
[CUSTOMER][NEUTRAL] OK. You are on hold.
[AGENT][POSITIVE] Wow
[AGENT][NEUTRAL] Hi [PII] this is [PII] back with you again so it's the same situation with this one there is not a claim on file at all for this one.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Yes, thank you so much for that permission. You previously told the policy and the time filing and mailing address the same as well, right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] Yes, thank you so much for that information. May I know the cloud reference number, please?
[AGENT][NEUTRAL] May you have what is it, please?
[CUSTOMER][NEUTRAL] May I know the call reference number, please?
[AGENT][NEUTRAL] Yes you can use my name [PII] and today state.
[CUSTOMER][POSITIVE] Yes, thank you so much, [PII]. That's fine now. Thanks for asking. Have a great day. Bye.
[AGENT][POSITIVE] You too. Bye-bye, [PII]. Thanks for calling APL.