AccountId: 011433970860
ContactId: 589fe59b-ee71-4f34-ab92-668d3064c98d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 350100 ms
Total Talk Time (AGENT): 139224 ms
Total Talk Time (CUSTOMER): 94723 ms
Interruptions: 1
Overall Sentiment: AGENT=0.9, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/16/589fe59b-ee71-4f34-ab92-668d3064c98d_20250116T19:43_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, good morning. This is [PII] calling from the provider's office to check the claim status.
[AGENT][NEUTRAL] I'm sorry, what was your name? I didn't understand you.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] It is [PII]
[AGENT][NEUTRAL] I'm sorry, can you spell that again?
[CUSTOMER][NEUTRAL] Yes, it's spelled as [PII].
[AGENT][NEUTRAL] OK, [PII]
[AGENT][NEUTRAL] And what was the next?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK. Thank you, [PII] and your callback number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And how many claims, [PII], do you have to check status on?
[CUSTOMER][NEUTRAL] One claim.
[AGENT][NEUTRAL] OK, yes, I can help you with that. And what is that policy number, please?
[CUSTOMER][NEUTRAL] 1262468 M as in Mike. L as in Lima 8.
[AGENT][NEUTRAL] OK thank you one moment.
[AGENT][NEUTRAL] And any information that I do provide for you today will be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth?
[CUSTOMER][NEUTRAL] [PII] with the date of birth [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And what is the date of service and total bill amount, please?
[CUSTOMER][NEUTRAL] It is uh
[CUSTOMER][NEUTRAL] [PII] with the bill amount $599 even.
[AGENT][POSITIVE] Thank you one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and you did say the date of service is [PII]. Is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, we do not have a claim on file for her for that date of service.
[CUSTOMER][NEUTRAL] For $599 even.
[AGENT][NEUTRAL] No claim on file.
[CUSTOMER][NEUTRAL] No
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] May I know the mailing address?
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the zip code is [PII].
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] And the zip code is?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] 7
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome. And with this.
[CUSTOMER][NEUTRAL] May I know the members affected it from that.
[AGENT][NEUTRAL] Effective date is [PII].
[CUSTOMER][NEUTRAL] Mhm. Terminate.
[AGENT][NEUTRAL] And with this, you, there is no term date, the policy is active?
[CUSTOMER][NEUTRAL] S
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And we must also have a copy of the primary insurance company's explanation of benefits.
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] Copy of the primary.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Along with the claim for review.
[CUSTOMER][NEUTRAL] Along with the claim.
[CUSTOMER][NEUTRAL] OK. May I know the payer ID?
[AGENT][NEUTRAL] 60801.
[CUSTOMER][NEUTRAL] OK. May I know the fax number?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] 87
[CUSTOMER][NEUTRAL] Thank you. May I know the timely finding limit?
[AGENT][NEGATIVE] No timely filing.
[AGENT][NEUTRAL] And once the claim has been processed, no.
[CUSTOMER][NEUTRAL] No
[CUSTOMER][NEUTRAL] Mhm, OK, OK.
[AGENT][NEUTRAL] Timely filing and processing with APL. You may go to our portal for claim status and the explanation of benefits for APL.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] and the
[CUSTOMER][POSITIVE] That's right
[AGENT][POSITIVE] And that website for our portal is secured.
[CUSTOMER][NEUTRAL] And that website
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Thank you so much.
[CUSTOMER][NEUTRAL] Can I get a call reference?
[AGENT][POSITIVE] Yes, sir, you're very welcome.
[AGENT][NEUTRAL] My name along with today's date.
[CUSTOMER][NEUTRAL] OK. Could you please spell your name?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][POSITIVE] Thank you so much, [PII], for assisting me and have a nice day.
[AGENT][NEUTRAL] Yeah
[AGENT][POSITIVE] You're very welcome, [PII]. So is there anything else that I can help you with?
[CUSTOMER][NEUTRAL] No.
[AGENT][POSITIVE] OK, well then, thank you again for calling APL and I hope you have a nice afternoon.
[CUSTOMER][POSITIVE] Have a nice.
[CUSTOMER][POSITIVE] Thank you.