AccountId: 011433970860
ContactId: 4493a376-a4d4-463f-a913-533f2083c0a9
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 299640 ms
Total Talk Time (AGENT): 122011 ms
Total Talk Time (CUSTOMER): 131908 ms
Interruptions: 2
Overall Sentiment: AGENT=0.6, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/23/4493a376-a4d4-463f-a913-533f2083c0a9_20250523T13:58_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] The
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah, hi, my name is [PII] calling for private office to check on claim status.
[AGENT][NEUTRAL] OK, [PII], you're needing claim status. Is that correct?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] Yes, I can help you with that. What is your callback number?
[CUSTOMER][NEUTRAL] Your callback number? [PII] is a direct line.
[AGENT][NEUTRAL] Thank you. And how many claims [PII], do you have to check status on?
[CUSTOMER][NEUTRAL] Go on.
[AGENT][NEUTRAL] OK, and I can help you. What is the member's policy number?
[CUSTOMER][NEUTRAL] Policy number? It's 15549006.
[AGENT][NEUTRAL] 15549006. Is that correct?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] Thank you one moment.
[AGENT][NEUTRAL] And [PII], any information that is provided today will be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] It's uh [PII]. My date of birth is [PII].
[AGENT][NEUTRAL] Thank you. The data service and total bill amount, please.
[CUSTOMER][NEUTRAL] It's [PII] and the total charges. On [PII].
[AGENT][NEUTRAL] I'm sorry, January.
[AGENT][NEUTRAL] OK, one moment. One moment, [PII]. What is the date again? [PII]. OK.
[CUSTOMER][NEUTRAL] For
[CUSTOMER][NEUTRAL] It's, it's [PII]. And the bill amount. It's $191 even.
[AGENT][NEUTRAL] Yes, sir, and the bill amount.
[AGENT][NEUTRAL] OK, so again, the data service is 124 of 2025 for $191. Is that correct?
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Is that correct yeah.
[AGENT][NEUTRAL] OK, so we do not have a claim on file for this member for that data service.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] That in December.
[AGENT][NEUTRAL] Now when the claim is submitted to us for review, [PII], we will have to have a copy of the primary insurance company's explanation of benefits along with the claim for review.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] of benefits.
[AGENT][NEUTRAL] And then once we have processed our claim here at APL you should also be able to check our claim status if you go to our portal and the website for our portal is located at [PII].
[CUSTOMER][NEUTRAL] For you.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] also
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] To our
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] The key word
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. Uh, could you please tell me the patient effective date and term date for the room?
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] This supplemental policy is active with an effective date of [PII], no term date.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][POSITIVE] That's perfect.
[CUSTOMER][NEUTRAL] OK. May I know the payer ID?
[AGENT][NEUTRAL] 60801.
[CUSTOMER][NEUTRAL] 01.
[CUSTOMER][NEUTRAL] And may I know the time if I limit to submit a claim.
[AGENT][NEGATIVE] There is no timely filing limit?
[CUSTOMER][NEUTRAL] I filing on.
[CUSTOMER][NEUTRAL] OK. May I know the contact number for this one?
[AGENT][NEUTRAL] Is my name that I gave you along with today's date.
[CUSTOMER][NEUTRAL] Could you please tell me your name again for the documentation purpose?
[AGENT][NEUTRAL] My name is [PII]
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And is there anything else, [PII], I can help you?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] I see.
[AGENT][NEUTRAL] It is spelled [PII]
[CUSTOMER][NEUTRAL] That.
[CUSTOMER][NEUTRAL] So.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][POSITIVE] Thanks for your information. Have a great day.
[AGENT][POSITIVE] OK, well, you're very welcome so that's all I can.