AccountId: 011433970860
ContactId: 568b1540-c95c-4883-b7ed-a90c389acd68
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 470500 ms
Total Talk Time (AGENT): 145456 ms
Total Talk Time (CUSTOMER): 148829 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/18/568b1540-c95c-4883-b7ed-a90c389acd68_20250418T17:19_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII] I'm calling for a Proda Williams Medical Group to check a claim status.
[AGENT][POSITIVE] All right. I'm happy to check on a claim for you today, [PII] Can I get the patient's policy number?
[CUSTOMER][NEUTRAL] Yeah, of course, it is 025665666.
[AGENT][NEUTRAL] All right. And do you have a good callback number?
[CUSTOMER][NEUTRAL] Yes, the callback number is [PII].
[AGENT][NEUTRAL] Right. And then patient's name and date of birth?
[CUSTOMER][NEUTRAL] Patient name is uh [PII]. Date of birth, [PII].
[AGENT][NEUTRAL] Thank you. And then what is the date of service?
[CUSTOMER][NEUTRAL] Date of service is uh.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the build out?
[CUSTOMER][NEUTRAL] And they put the amount is $620 even.
[AGENT][NEUTRAL] No claims on file for date of service [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yeah, we don't have any claims on file for the [PII], [PII]
[CUSTOMER][NEUTRAL] OK, no problem. May I know the special plan effective date and termination date?
[AGENT][NEUTRAL] No termination date. Policy effective date is one.
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Thank you. Can I have a uh claim mailing address and time to call limit?
[AGENT][NEUTRAL] No timely filing claims mailing address is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] That's in [PII].
[AGENT][NEUTRAL] Zip code is [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] And are you the secondary insurance for this patient?
[AGENT][NEUTRAL] Yes, we are the secondary.
[CUSTOMER][NEUTRAL] And uh
[CUSTOMER][NEUTRAL] What is the time for the limit to submit a claim?
[AGENT][NEGATIVE] No timely filing limit.
[CUSTOMER][NEUTRAL] Oh, sorry.
[CUSTOMER][NEUTRAL] And uh
[CUSTOMER][NEUTRAL] Is there any electronic payer ID?
[AGENT][NEUTRAL] Payer ID is 60801.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And uh do we have to submit claims through paper or electronic?
[AGENT][NEUTRAL] They can be submitted
[CUSTOMER][NEUTRAL] How we have to submit a claim.
[AGENT][NEUTRAL] Either way.
[CUSTOMER][POSITIVE] Oh, OK. Thank you.
[CUSTOMER][NEUTRAL] And I have another patients claim to look. Can you help me on it?
[AGENT][NEUTRAL] Uh, yeah, let me just notate this and then we can move on to the next one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] All right. And then, what is the next patient's ID?
[CUSTOMER][NEUTRAL] Uh, before moving, what would be the reference number for this patient?
[AGENT][NEUTRAL] Call reference is my name with my initial to my last name and then today's date, that'll be for all claims. My name is [PII], that is spelled [PII] to my last name is [PII], and then today's date.
[CUSTOMER][POSITIVE] Oh, OK, got it. Thank you, [PII].
[CUSTOMER][NEUTRAL] So the next patient ID is 190.
[CUSTOMER][NEUTRAL] 561 9.
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] Patient name is uh [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK. Data service.
[CUSTOMER][NEUTRAL] Uh date of service is uh [PII].
[AGENT][NEUTRAL] [PII]. OK, and bill them out?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] It is $168 even.
[AGENT][NEUTRAL] No claims on file for [PII].
[CUSTOMER][NEUTRAL] OK. So the mailing address, pay ID, everything will be same, right?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] And for this patient, what would be the effective date and termination date?
[AGENT][NEUTRAL] Uh, looks like the effective date for the patient is [PII].
[AGENT][NEUTRAL] No termination date policy is still active.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] And actually while submitting the secondary claims, uh, do we need to attach a primary OB?
[AGENT][NEUTRAL] Yes, please.
[CUSTOMER][NEUTRAL] Or is it not required?
[AGENT][NEUTRAL] Yes, it is required.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Thank you, [PII]. And I have one last claim uh for a different patient.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] Alright, what's the next patient ID?
[CUSTOMER][NEUTRAL] It is 022.
[CUSTOMER][NEUTRAL] 471
[CUSTOMER][NEUTRAL] 72
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] Patient name is [PII]. Date of birth [PII].
[AGENT][NEUTRAL] Alright thank you and then data service.
[CUSTOMER][NEUTRAL] Uh date of service is uh [PII].
[AGENT][NEUTRAL] No claims on file for [PII].
[CUSTOMER][NEUTRAL] OK, got it.
[CUSTOMER][NEUTRAL] So all the details will be the same.
[AGENT][POSITIVE] Correct. Mhm.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] So for this patient, uh, what is the time limit?
[AGENT][NEGATIVE] Uh, there is no timely filing limit.
[CUSTOMER][NEUTRAL] Oh sorry, uh, the plan of date and termination date.
[AGENT][NEUTRAL] Uh, effective date for patient is [PII].
[AGENT][NEUTRAL] No termination date, patient is still active.
[CUSTOMER][NEUTRAL] [PII], right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] OK. Thank you for your assistance so far. You've been very much helpful.
[AGENT][POSITIVE] You're welcome. Have a good day.
[CUSTOMER][NEUTRAL] You too bye.
[AGENT][NEUTRAL] Bye bye.