AccountId: 011433970860
ContactId: 4494c525-33d3-484f-aa71-183f345d5cc7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1478359 ms
Total Talk Time (AGENT): 332774 ms
Total Talk Time (CUSTOMER): 407440 ms
Interruptions: 1
Overall Sentiment: AGENT=0.9, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/14/4494c525-33d3-484f-aa71-183f345d5cc7_20250414T14:13_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Uh hello. My name is [PII]. I'm calling from provider's office looking for the claim status.
[AGENT][NEUTRAL] Of course, I can help you with claim status today. What did you say your name was again?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and then do you have the policy number on you?
[CUSTOMER][NEUTRAL] Yes. So the member ID number is 01936826.
[AGENT][POSITIVE] OK, perfect, thank you.
[AGENT][NEUTRAL] And then what's a good callback number in case our call gets dropped?
[CUSTOMER][NEUTRAL] Uh, OK. So the callback number is
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, perfect. Thank you.
[AGENT][NEUTRAL] All right. And the patient's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Member first name is [PII] and the last name is [PII]. Date of birth is [PII].
[CUSTOMER][NEUTRAL] And by the way, what's your name?
[AGENT][NEUTRAL] My name is [PII].
[CUSTOMER][NEUTRAL] OK, yeah.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] OK, and then do you have a date of service and a charge amount?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It is [PII].
[CUSTOMER][NEUTRAL] And the total charge amount was $288.55.
[AGENT][POSITIVE] Perfect, thank you.
[AGENT][NEUTRAL] And for that data service, did you say [PII]?
[CUSTOMER][NEUTRAL] No, it is
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Oh, OK, February. OK.
[CUSTOMER][NEUTRAL] It
[AGENT][NEUTRAL] OK, so there are no claims on file for that data service as of right now.
[CUSTOMER][NEUTRAL] OK. Can you tell me what is the POID?
[AGENT][NEUTRAL] The payer ID?
[CUSTOMER][NEUTRAL] Electronic ID yes.
[AGENT][NEUTRAL] Just one moment.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK. It looks like the payer ID is 20998.
[CUSTOMER][NEUTRAL] OK, no problem. And what is the patient's eligibility?
[AGENT][NEUTRAL] And it looks like this policy is active.
[AGENT][NEUTRAL] And the effective date is [PII].
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Two current, right?
[AGENT][NEUTRAL] Yes, policy is active currently. Mhm.
[CUSTOMER][POSITIVE] Uh, OK, no problem. Thank you so much for this information. Are you ready for the next patient?
[AGENT][NEUTRAL] Yes, do you have another patient you're checking claims for?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, that's fine. Uh, just one moment.
[CUSTOMER][NEUTRAL] Like
[AGENT][NEUTRAL] OK. And the policy number for that patient?
[CUSTOMER][NEUTRAL] It is 024.
[CUSTOMER][NEUTRAL] 39894 M as in Mike L as in Lima 8.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, and patient's first and last name and date of birth, please?
[CUSTOMER][NEUTRAL] OK. So the patient's first name is [PII] and the last name is [PII]. Date of birth is [PII].
[AGENT][POSITIVE] Perfect, thank you.
[AGENT][NEUTRAL] OK, and then do you have a data service and a charge amount?
[CUSTOMER][NEUTRAL] [PII], total charge amount is $615 even.
[AGENT][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] And how about your day? How was your day going so far?
[AGENT][POSITIVE] Good. How is your day going?
[CUSTOMER][NEUTRAL] OK. So, today is Monday, you know.
[AGENT][POSITIVE] Yes, it is, it does.
[CUSTOMER][NEUTRAL] What is going?
[AGENT][NEUTRAL] It does feel like a Monday, huh? And it is.
[AGENT][NEUTRAL] OK, so it looks like for that date of service there is also no claim on file as of right now.
[CUSTOMER][NEUTRAL] OK, so the payer ID you said that, it is 20998. Is that correct?
[AGENT][NEUTRAL] Uh, for the last patient.
[CUSTOMER][NEUTRAL] OK. And what about this patient?
[AGENT][NEUTRAL] 16291.
[CUSTOMER][NEUTRAL] 16291, right?
[AGENT][POSITIVE] Yes, sir. Yes, correct.
[CUSTOMER][NEUTRAL] OK. So,
[CUSTOMER][NEUTRAL] According to my system, I'm not able to find the electronic ID you are providing me. Just bear with me.
[CUSTOMER][NEUTRAL] Well
[CUSTOMER][NEUTRAL] Uh, OK, no problem. So, can you tell me what is your claim mailing address so we can send all the claim on the correct mailing address.
[AGENT][NEUTRAL] It is [PII].
[CUSTOMER][NEUTRAL] But I
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]. Is that correct?
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Just give me one second so we can send all this claim to your.
[AGENT][NEUTRAL] Yes, sir. Mhm. Yes, that's correct, mailing address.
[CUSTOMER][NEUTRAL] Mailing address, right?
[AGENT][NEUTRAL] Oh sorry, the payer ID is 60801 for those.
[CUSTOMER][NEUTRAL] Oh, so there's no reason I was not able to find the electronic I pay ID in my system. So, yes, can you tell me one more time what was the payer ID?
[AGENT][NEUTRAL] Yes, I'm so sorry. It's 60.
[AGENT][NEUTRAL] 801.
[CUSTOMER][NEUTRAL] Just give me 1 2nd.
[CUSTOMER][NEUTRAL] Let me verify my system.
[CUSTOMER][NEUTRAL] Uh yes, so this parody is found in my system. So it is for the old patient, right?
[AGENT][NEUTRAL] Yes, it is for both of them.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, and can you tell me about the eligibility for this patient?
[AGENT][NEUTRAL] Yes, sir, I can. Just one moment.
[AGENT][NEUTRAL] OK, this policy is active. The effective date is [PII].
[CUSTOMER][NEUTRAL] To current, right?
[AGENT][POSITIVE] Yes. Correct.
[CUSTOMER][POSITIVE] OK. Thank you so much for this information.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] Are you ready for the next patient? Uh, we just need, from right now, we just need to verify the patient's eligibility, OK? So we will work fast.
[AGENT][NEUTRAL] OK, and then what's that policy number?
[CUSTOMER][NEUTRAL] So the next member ID are ready for the member, ma.
[CUSTOMER][NEUTRAL] It is 1973189.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] OK, perfect.
[CUSTOMER][NEUTRAL] Maybe
[AGENT][NEUTRAL] OK, and patient's first and last name and date of birth, please?
[CUSTOMER][NEUTRAL] Patient, first name is [PII] and the last name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK, and we're just checking eligibility for him.
[CUSTOMER][NEUTRAL] Yes, just eligibility.
[AGENT][NEUTRAL] Oh sorry, her. Yes. Uh, so it looks like the policy is active and the effective date is [PII].
[CUSTOMER][NEUTRAL] To correct, right?
[AGENT][POSITIVE] Yes, correct.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK, so the next policy ID is
[CUSTOMER][NEUTRAL] 018
[CUSTOMER][NEUTRAL] 26085 M as in Mike, L as in Lima, number 8.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Just one moment.
[AGENT][NEUTRAL] OK. Patience's first and last name, please, and date of birth.
[CUSTOMER][NEUTRAL] Patient 1st, 1st name is [PII] and the last name is [PII]. Date of birth is [PII]. For this patient, check the patient's claim as well, OK? Have you received any claim?
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] Do you have the data service and charge amount?
[CUSTOMER][NEUTRAL] We
[CUSTOMER][NEUTRAL] It is the service is [PII]. Charge amount is $150 even.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, there is no claim on file for that data service as of right now.
[CUSTOMER][POSITIVE] There is no claim on file. OK, no problem.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh, and what is the patient eligibility date?
[AGENT][NEUTRAL] So, just one moment.
[AGENT][NEUTRAL] So the policy is active. The effective date is [PII].
[CUSTOMER][NEUTRAL] To current, right?
[AGENT][POSITIVE] Yes, correct.
[CUSTOMER][NEUTRAL] OK, no problem. Are you ready for the next member ID?
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Yes, what is it?
[CUSTOMER][NEUTRAL] It is 1224175 L as in Lima, L as in Lima again, number 8.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. Patient's first and last name and date of birth, please?
[CUSTOMER][NEUTRAL] OK first name is [PII] and the last name is [PII]. Date of birth is [PII]. The service is [PII].
[AGENT][NEUTRAL] OK, and charge amount?
[CUSTOMER][NEUTRAL] 1000 to $100 even.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] OK, there is no claim on file for this state of service as of right now.
[CUSTOMER][POSITIVE] Oh, OK, no problem.
[CUSTOMER][NEUTRAL] Eligibility date.
[AGENT][NEUTRAL] OK, it looks like this policy is no longer active, the effective date.
[AGENT][NEUTRAL] Is [PII].
[CUSTOMER][NEUTRAL] What is the termination date?
[AGENT][NEUTRAL] So.
[AGENT][NEUTRAL] Just a moment.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] OK, no problem.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And then we also have an online service center.
[AGENT][NEUTRAL] If you would like to sign up, it's [PII] to check claim status.
[CUSTOMER][NEUTRAL] OK. So after this patient that I only last two patients left. So next time I'll take care of this.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] That's fine.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK. So the next member ID is [PII] [PII].
[AGENT][POSITIVE] OK. Thank you.
[AGENT][NEUTRAL] OK. Patient's first and last name and date of birth, please?
[CUSTOMER][NEUTRAL] Patients first name is [PII] and the last name is [PII]. And the date of birth is [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, are we checking claim status for this patient as well?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And date of service and charge amount please.
[CUSTOMER][NEUTRAL] It is [PII] and the charge amount is $150 even.
[CUSTOMER][NEUTRAL] Just checking, have you received any claim for the data service.
[AGENT][NEUTRAL] OK, and you said $150?
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, and it looks like for this state of service and charge amount for this claim we are awaiting the EOB.
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] So you have received the claim, right?
[AGENT][NEUTRAL] Yes, we have, and we're just waiting for the EOB from their provider.
[CUSTOMER][NEUTRAL] OK, no problem. So you have a claim.
[AGENT][NEUTRAL] Yes, would you like that claim number?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK. So first time on which date you have received this claim?
[AGENT][NEUTRAL] Yes, we have. Mhm.
[CUSTOMER][NEUTRAL] Received it
[AGENT][NEUTRAL] See, just one moment.
[AGENT][NEUTRAL] OK, so it looks like the received date is [PII].
[AGENT][NEUTRAL] And then the process date was [PII].
[CUSTOMER][NEUTRAL] Claim number?
[AGENT][NEUTRAL] It is 355-55997.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK. Just wait.
[CUSTOMER][NEUTRAL] OK, what is the fax number so we can submit your uh EOP through uh via fax.
[AGENT][POSITIVE] OK, yes, I can provide that for you.
[AGENT][NEUTRAL] Our fax number is [PII].
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] That's like.
[CUSTOMER][NEUTRAL] Are
[AGENT][NEUTRAL] 365.
[CUSTOMER][NEUTRAL] We get we get we get.
[AGENT][NEUTRAL] 94.
[AGENT][NEUTRAL] 23.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, so we, we just need to submit a primary PDOB via fax. Do you need any additional information?
[AGENT][POSITIVE] Yes, that is correct.
[CUSTOMER][NEUTRAL] I'm asking, do you need any additional information with primary ADOB?
[AGENT][NEUTRAL] No, that is it. We're just awaiting the EOB.
[CUSTOMER][POSITIVE] Uh, OK, no problem. Thank you so much for this information. Are you ready for the next last patient?
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Yes, I am ready.
[CUSTOMER][NEUTRAL] 01982592 M as in Mike, L as in Lima number 8.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK. Patient's first and last name and date of birth, please?
[CUSTOMER][NEUTRAL] first name is [PII] and the last name is [PII]. Date of birth is [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And then are we checking claim status for this one as well?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And then what's the date of service and the charge amount?
[CUSTOMER][NEUTRAL] Data service is [PII]. Charge amount is $150 even.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, and for that data service there is no claim on file as of right now.
[CUSTOMER][NEUTRAL] OK. What, what is the patient's eligibility date?
[AGENT][NEUTRAL] It looks like this policy is active and the effective date was [PII].
[CUSTOMER][NEUTRAL] OK, no problem. What is gonna be the reference number?
[AGENT][NEUTRAL] Uh, it would be Hailey, which is my first name.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Last initial [PII]
[AGENT][NEUTRAL] And then today's date.
[CUSTOMER][POSITIVE] Oh, OK, no problem. You helped me a lot today. Have a great.