AccountId: 011433970860
ContactId: 4c68d365-2057-4c88-95d0-f0e1582908c6
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 482399 ms
Total Talk Time (AGENT): 86579 ms
Total Talk Time (CUSTOMER): 279491 ms
Interruptions: 0
Overall Sentiment: AGENT=-0.1, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/14/4c68d365-2057-4c88-95d0-f0e1582908c6_20250214T19:31_UTC.wav
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[AGENT][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] I.
[AGENT][NEUTRAL] Oh yeah
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Hello.
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII]. Actually I'm looking for a claim status. If you could, uh, if you could please help me the same.
[AGENT][NEUTRAL] I can help you, [PII]. What's the policy number?
[CUSTOMER][NEUTRAL] Yeah, just allow me, let me check it out, my.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh, so the patient policy number is 02549427.
[CUSTOMER][NEUTRAL] ML 7.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, what's a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah, the callback number is [PII].
[CUSTOMER][POSITIVE] Oh, I'm uh I'm really sorry. It is [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yeah, 775-578-0.
[AGENT][NEUTRAL] OK, thank you, give me one moment to pull up the file.
[CUSTOMER][NEUTRAL] OK, sure.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEGATIVE] Since I'm not OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It's a.
[CUSTOMER][NEUTRAL] Primary health insurance here.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Give me one moment.
[CUSTOMER][POSITIVE] OK, sure, take your time.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I know.
[CUSTOMER][NEUTRAL] See that.
[CUSTOMER][NEUTRAL] And I
[CUSTOMER][NEUTRAL] And they add the.
[CUSTOMER][NEUTRAL] My son with my with my.
[CUSTOMER][NEUTRAL] So.
[AGENT][NEUTRAL] What is the patient's name and date of birth, [PII]?
[CUSTOMER][NEUTRAL] We
[CUSTOMER][NEUTRAL] The patient name is [PII]. The date of birth is.
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Alright, thank you for that and we're checking claim status for what data service?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh date of, so I mean the uh date of service is [PII].
[AGENT][NEUTRAL] And what's the amount?
[CUSTOMER][NEUTRAL] The bill amount is 1800, sorry.
[CUSTOMER][NEUTRAL] Yeah it's $10,847.68.
[AGENT][NEUTRAL] OK, $10,847 and what's the cent?
[CUSTOMER][NEUTRAL] 68, 68.
[AGENT][NEUTRAL] 68, OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] That
[AGENT][NEUTRAL] Alright, I do not see that date of service on file for Elder.
[CUSTOMER][NEUTRAL] Just a moment, OK, let me check it out one second. Yeah, I, yeah, I can see that the date of service is [PII], as well as I also can see that we actually initially bill this claim to primary, that is the, the primary is BCBS HMO, yeah, so, uh, that, uh, um health options.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Just a moment, let me, let me reconfirm it from my end.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Uh yeah, so here I can see that uh we initially build this claim to.
[CUSTOMER][NEUTRAL] BCBS as primary and uh primary already processed the claim and uh now the I mean whatever the uh I mean whatever patient uh responsibility was applied by the primary that was billed to you.
[AGENT][NEUTRAL] And I'm saying we've not received the clay mark. It's not on file in our office.
[CUSTOMER][NEUTRAL] OK, so, mm, uh, just allow me, let me, let me check with my other tools so that I can verify how the claim was signed, OK?
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] That's
[CUSTOMER][NEUTRAL] Yeah, so here you can see that the claim was uh sent by paper.
[CUSTOMER][NEUTRAL] And uh could you please confirm the mailing address?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] So that I can verify. Just a moment. Let me, let me make a note of it. So you said that uh your mailing address is [PII].
[AGENT][NEUTRAL] Mhm. [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII] correct or [PII] or [PII].
[AGENT][NEUTRAL] No
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Uh, sir, could you please spell, could you please spell it for me? [PII] [PII], yeah. Ooa, could you please spell that?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] OK [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The city
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And the zip code?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]. And uh also may I know what I mean, what is the timely filing limit?
[AGENT][NEGATIVE] Yeah, just submit a claim. There's no timely filing.
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] To submit a claim, there is no timely filing limit?
[CUSTOMER][NEUTRAL] Yeah, I'm asking about that I mean from the date of service it should be submitted within it uh time frame, right?
[AGENT][NEGATIVE] There is no timely filing submit.
[AGENT][NEUTRAL] Limit in which to send the claim.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][POSITIVE] OK, thank you so much.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Anything else?
[CUSTOMER][NEUTRAL] Mhm. And yeah, I just, I'm, I'm checking with this, uh, yeah, so, uh, this is all what I needed. Thank you so much. Have a great day. OK, and but the last thing, could you please help me the call reference number.
[AGENT][NEUTRAL] It's my name and today's date.
[CUSTOMER][NEUTRAL] Uh, so could you please spell your name for me?
[AGENT][NEUTRAL] [PII], first initial last name is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK, thank you so much. Have a great day. Take care. Bye-bye.
[AGENT][POSITIVE] OK, thank you for calling APL. Have a good day.