AccountId: 011433970860
ContactId: 4a277751-5255-4728-9004-11719953bd64
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 344750 ms
Total Talk Time (AGENT): 119001 ms
Total Talk Time (CUSTOMER): 92400 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/21/4a277751-5255-4728-9004-11719953bd64_20250221T16:05_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]. Yeah, I'm just trying to get status of the claim we sent in.
[AGENT][NEUTRAL] OK, I can help you with claim status. Can I please get your name and your callback number?
[CUSTOMER][NEUTRAL] Yes, my name is [PII]. Call back is [PII].
[AGENT][NEUTRAL] OK, thank you. And then what is the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Uh, so his name is [PII] His date of birth is [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And his ID number is 02006913.
[AGENT][NEUTRAL] OK, let me pull up that policy real quick.
[AGENT][NEUTRAL] OK, and can you give me the date of service, please?
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] And then the charge amount?
[CUSTOMER][NEUTRAL] 244244
[AGENT][NEUTRAL] Thank you. And then the name of the facility that you're calling from, please?
[CUSTOMER][NEUTRAL] Osborne Family Medicine.
[AGENT][NEUTRAL] OK, I'm gonna put you on a brief hold, [PII], while I pull in this claim for us and I'll be right back.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] Thank you, ma'am.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Hi [PII], this is [PII] back with you again. So looking on data service of [PII] for [PII], I do not find a claim on file for that data service for.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Born Family Medical.
[CUSTOMER][NEUTRAL] OK, um, so we sent it paper claim. Can I just get the address to make sure we sent it to the correct one?
[AGENT][NEUTRAL] Yes ma'am, the address is [PII].
[AGENT][NEUTRAL] And that's in [PII], and the zip code is [PII].
[CUSTOMER][NEUTRAL] Oh, OK, so we sent it to the [PII] address. Is that an old address?
[AGENT][NEUTRAL] The [PII] address. Let me look and see.
[CUSTOMER][NEUTRAL] Yeah, because I think we sent the our previous claim to [PII] as well.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So what I'll probably need to do is uh transfer you on over to IMA to see if they have a claim on file. Um, we work hand in hand with them. So if you would like, I can give you that phone number.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII] OK and then if IMA had received it, does that mean they process and pay it or does it get forwarded to you guys?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It depends on the dollar amount, but they process and pay from, from their facility.
[CUSTOMER][NEUTRAL] OK, um, and then going forward for future claims for this patient, should we continue to send claims to IMA or should we send it to APL?
[AGENT][NEUTRAL] Uh, always send it to the client's address that's on the back of the card.
[CUSTOMER][NEUTRAL] Got you. OK. And then would you happen to know what the timely filing is or would I need to ask IMA?
[AGENT][NEUTRAL] I'm not sure what there is, but we don't have one.
[AGENT][NEGATIVE] As long as they're covered on the data service we don't have a timely filing.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Limit.
[CUSTOMER][POSITIVE] That's lovely to hear.
[AGENT][POSITIVE] Yes, it's a big benefit.
[CUSTOMER][POSITIVE] Right, OK, sorry, I'll give them a call. Thank you so much. Can I get a reference number, please?
[AGENT][NEUTRAL] Yes ma'am, you can use my name [PII] and today's date.
[CUSTOMER][POSITIVE] [PII] thank you so much have a good one.
[AGENT][POSITIVE] You too, thank you for calling APL you take care.
[AGENT][NEUTRAL] Mm, bye-bye.
[CUSTOMER][POSITIVE] Thank you bye bye.