AccountId: 011433970860
ContactId: 5982eaa7-df9a-4169-82a5-efda2467540e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1439390 ms
Total Talk Time (AGENT): 216516 ms
Total Talk Time (CUSTOMER): 455382 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/04/5982eaa7-df9a-4169-82a5-efda2467540e_20250604T18:58_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Oh, hi, [PII]. My name is [PII] calling from provider office and I'm looking for a claim status.
[AGENT][NEUTRAL] Yeah, I can help you with claim status. [PII]. Do you have a good callback number?
[CUSTOMER][NEUTRAL] Yes, I do. So the phone number is [PII].
[CUSTOMER][NEUTRAL] [PII]. It's my right.
[AGENT][NEUTRAL] OK, thank you. And the policy number for the patient?
[CUSTOMER][NEUTRAL] Uh, the member I have 019.
[CUSTOMER][NEUTRAL] 88944 M as in Mike, L as in Lima, number 8.
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] Patient name will be [PII] and the date of birth will be [PII].
[AGENT][NEUTRAL] Data service and bill charges?
[CUSTOMER][NEUTRAL] So the data service I have [PII] and the bill amount, the total charge will be $2,235 even 22 $35.
[AGENT][NEUTRAL] That was [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] The charges were 2025 or I'm sorry, what was it?
[CUSTOMER][NEUTRAL] Uh, 2, it is $2,235 even 2235.
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] I've got a facility claim for that date, but it's for a different amount. Is this for physician charges?
[CUSTOMER][NEUTRAL] Uh, yes. So, so maybe can you check, do you have for $320.04? You know, actually, the overall charge will be $2,235 and there was in a couple of amount was paid by different insurance. And I'm sorry, you know, initially, the claim was submitted to BCBS and uh they have processed the claim as a deductible, $320.04.
[CUSTOMER][NEUTRAL] And the claim, so that's why we billed to you guys, the American Public Life Insurance for the amount.
[AGENT][NEUTRAL] So it's, it's a facility claim or a physician claim?
[CUSTOMER][NEUTRAL] So.
[AGENT][NEUTRAL] Leisure time.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Do you have one of the CPT codes, procedure codes?
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] CBD code, yes, let me take a look one second.
[CUSTOMER][NEUTRAL] Mhm. OK, there we are. So, it is uh 99291.
[AGENT][NEUTRAL] OK, yeah, I don't show that claim on file.
[CUSTOMER][NEUTRAL] OK, so that was in a claim.
[CUSTOMER][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] OK. And did you have a member plan effective date?
[AGENT][NEUTRAL] Effective [PII].
[AGENT][NEUTRAL] And it terminated [PII].
[CUSTOMER][NEUTRAL] OK. So the member was active on the desk, right? Uh.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] OK, then awesome. Thank you. And what is the payer ID?
[AGENT][NEUTRAL] The ID is 60801.
[CUSTOMER][NEUTRAL] It is uh 60801.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK. And what is the mailing address to submit that?
[AGENT][NEUTRAL] Mailing address is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][POSITIVE] OK then awesome.
[CUSTOMER][NEUTRAL] And what is the time frame to submit the claim?
[AGENT][NEGATIVE] And there's no timely filing limit.
[CUSTOMER][POSITIVE] OK. So, no. Awesome. [PII], thank you so much. And you know, [PII], I do have a couple of patients to check your claim. Uh, could you hold that for me?
[AGENT][NEUTRAL] Uh, yes. What's the um policy number?
[CUSTOMER][NEUTRAL] Uh, before I do have a reference number for this member?
[AGENT][NEUTRAL] Uh, reference number will be the same for all. Uh, it's my name, [PII], first initial to last name [PII], and today's date.
[CUSTOMER][NEUTRAL] OK, then it's uh your your name and the date.
[CUSTOMER][POSITIVE] Then, OK. Then awesome thank you so much, [PII]. And uh the next member ID I have, let me know when you're ready. I will give you the member ID.
[AGENT][POSITIVE] I'm ready.
[CUSTOMER][NEUTRAL] OK. So the next one I have 022.
[CUSTOMER][NEUTRAL] 660
[CUSTOMER][NEUTRAL] 30 M as in Mike, L as in Lima, number 7.
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] So the member name will be, one moment.
[CUSTOMER][NEUTRAL] You know, uh the first name and the last name will be, one moment, let me confirm.
[CUSTOMER][NEUTRAL] OK, there we go. So, the last name uh [PII] and the date of birth will be [PII].
[AGENT][NEUTRAL] D of service and bill charges.
[CUSTOMER][NEUTRAL] Uh, this one, the data service I have [PII].
[CUSTOMER][NEUTRAL] It's a 2023 claim and uh the bill amount will be $1,273 1273.
[AGENT][NEUTRAL] OK, looks like this policy term 10-1-2023, um, but they have a different policy. Let me pull that up.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 1,273, is that right?
[CUSTOMER][NEUTRAL] Uh, double the amount. Uh, let me confirm. Yes, 1,273, correct.
[AGENT][NEUTRAL] That was received on [PII].
[AGENT][NEUTRAL] Process [PII].
[AGENT][NEUTRAL] Uh, we needed a copy of the primary explanation of benefits.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. So you guys need a year from the primary insurance. And uh I just wanna confirm who is the primary carrier for the member.
[AGENT][NEUTRAL] Yeah, it
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Yeah, we got Amed.
[CUSTOMER][NEUTRAL] OK. So the I made is a primary. OK, then. And do you have a claim number?
[AGENT][NEUTRAL] Claim number is.
[AGENT][NEUTRAL] Give me just a moment.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] 3500565.
[CUSTOMER][NEUTRAL] OK. So, it is 350-0565, correct?
[AGENT][NEUTRAL] Yes, and then the policy number?
[AGENT][NEUTRAL] It's 241.
[AGENT][NEUTRAL] 9347.
[CUSTOMER][NEUTRAL] 241-9347. OK. So this one is a current member ID.
[CUSTOMER][POSITIVE] OK. Then awesome. Thank you so much. And uh this one, can you send you a copy to my fax number?
[AGENT][NEUTRAL] What's your facts?
[CUSTOMER][NEUTRAL] So, the fax number is [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] It's like uh my, the phone number, but only the two digits was different.
[CUSTOMER][NEUTRAL] Anything with the [PII].
[AGENT][NEUTRAL] OK, give me one moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] OK, and the other the next policy number.
[CUSTOMER][NEUTRAL] OK. So the next one before this one, how long it will take to receive a UB?
[AGENT][NEUTRAL] Uh, probably just a few minutes.
[CUSTOMER][POSITIVE] OK, then. Then, thank you.
[CUSTOMER][NEUTRAL] And uh the next member ID I have.
[CUSTOMER][NEUTRAL] One moment.
[CUSTOMER][POSITIVE] So, thank you so much for being patient. And the next member ID I have 021.
[CUSTOMER][NEUTRAL] 068
[CUSTOMER][NEUTRAL] 90 M as in Mike, L as in Lima, number 8.
[AGENT][NEUTRAL] And patient name and date of birth?
[CUSTOMER][NEUTRAL] Uh, this one the member name one moment.
[CUSTOMER][NEUTRAL] I know. OK. It's uh I and the last name will be [PII] and the date of birth I have [PII].
[AGENT][NEUTRAL] And the date of service and bill charges?
[CUSTOMER][NEUTRAL] Oh, the data service, I have [PII].
[CUSTOMER][NEUTRAL] And uh the bill amount is $2,032 even.
[AGENT][NEUTRAL] OK, looks like this policy is term, but there's a more active one. Let me get that pulled up.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Uh, that one was received 93-2024. Proceed 95-2024.
[AGENT][NEUTRAL] A copy of the primary explanation of benefits.
[CUSTOMER][NEUTRAL] OK. So, this one also need a primary AB.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK. Then uh
[CUSTOMER][NEUTRAL] This show on what is the claim number?
[AGENT][NEUTRAL] Claim number is 350-1583.
[CUSTOMER][NEUTRAL] OK. 350-1583. And what is the member new member, I mean, new member ID?
[AGENT][NEUTRAL] Member ID is 2266303.
[CUSTOMER][NEUTRAL] OK, then, perfect. And this one also, can you send the UB to the same fax number?
[AGENT][NEUTRAL] Yes, give me one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and the next policy number?
[CUSTOMER][NEUTRAL] Mm, one moment.
[CUSTOMER][NEUTRAL] OK. So, the next policy I have.
[CUSTOMER][NEUTRAL] 021
[CUSTOMER][NEUTRAL] 378
[CUSTOMER][NEUTRAL] 83 M as in Mike, L as in Lima, number 8.
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] Uh, member first name will be [PII].
[CUSTOMER][NEUTRAL] And the last name will be [PII] and uh the date of birth will be [PII].
[AGENT][NEUTRAL] And date of service and bill charges?
[CUSTOMER][NEUTRAL] Uh, the data service will be [PII].
[CUSTOMER][NEUTRAL] And uh the bill amount is $2,304 even. 2304.
[AGENT][NEUTRAL] OK, it looks like this policy is charm. Let me look up the new one.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] And what was the date of service, sorry.
[CUSTOMER][NEUTRAL] Mm, it is uh [PII].
[AGENT][NEUTRAL] OK. Uh, looks like we received that um.
[AGENT][NEUTRAL] Excuse me, received 93-2024 process 95 2024.
[AGENT][NEUTRAL] And
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Uh, maximum benefit payable for date of service was met, dollar amount.
[CUSTOMER][NEUTRAL] OK. So maximum benefit to reach in dollars, OK?
[CUSTOMER][NEUTRAL] And uh what is the claim number?
[AGENT][NEUTRAL] Number 350-1694.
[CUSTOMER][NEUTRAL] OK, thank you. And what is the member name number ready?
[AGENT][NEUTRAL] Member ID is 2281863.
[CUSTOMER][NEUTRAL] OK, 63. Thank you. And this one also, can I send you to the same fax number?
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. Do you have another policy number?
[CUSTOMER][NEUTRAL] Uh, the next one will be
[CUSTOMER][NEUTRAL] So, the next one is uh
[CUSTOMER][NEUTRAL] 106
[CUSTOMER][NEUTRAL] 691 7.
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] Patient name will be [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] Date of service and bill charges.
[CUSTOMER][NEUTRAL] Uh, the data service I have [PII], and the bill amount is $710 even.
[AGENT][NEUTRAL] It was received 827-24. Proceed [PII].
[AGENT][NEUTRAL] And
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] We need a copy of the primary explanation of benefits.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So, this one, OK, then thank you so much. And this one, I just wanna confirm who is the primary insurance for this one?
[AGENT][NEUTRAL] Um, it is.
[AGENT][NEUTRAL] United Healthcare.
[CUSTOMER][POSITIVE] OK, awesome. And what is the claim number?
[AGENT][NEUTRAL] My number is
[AGENT][NEUTRAL] 349-99980.
[CUSTOMER][NEUTRAL] OK. And the policy number was the same, right? 1066917?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] OK, so this is a card. OK, then awesome. And this one also, can you send the UB to the same fax number?
[CUSTOMER][NEUTRAL] Hey
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] OK. The next policy.
[CUSTOMER][POSITIVE] Uh, no, I think I actually, I have only 5 lines then everything got it. I'm really appreci appreciate [PII], you're a good one.
[CUSTOMER][POSITIVE] Thanks so much for your assistance.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] Oh, you say that was the last one?
[CUSTOMER][POSITIVE] Oh yes, that was finished. I have only 5 clients, so everything was finished.
[AGENT][POSITIVE] Oh, OK. OK, thank you.
[AGENT][POSITIVE] OK, well thanks for calling APL. I hope you have a good day.
[CUSTOMER][NEUTRAL] You too. Bye-bye.