AccountId: 011433970860
ContactId: 5bc70005-b72d-4c8e-b8f9-0337fffefd60
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 385820 ms
Total Talk Time (AGENT): 103146 ms
Total Talk Time (CUSTOMER): 170879 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/12/5bc70005-b72d-4c8e-b8f9-0337fffefd60_20250212T14:52_UTC.wav
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[AGENT][POSITIVE] Good morning. Thanks for calling ATL. This is speaking. May I help you?
[CUSTOMER][NEUTRAL] Yeah, hi, very good morning to you. My name is [PII]. I'm calling you from the provider's office to check a claim status for a member.
[AGENT][NEUTRAL] OK, I can verify a claim status for you, [PII]. And what is the policy number, please?
[CUSTOMER][NEUTRAL] I don't have that DID number because it's a 90-degree benefits. I do have the name and date of birth. I spoke with them and they have transferred me here stating that American.
[CUSTOMER][NEUTRAL] Uh, are looking in this claim. So, can I give you the member name and date of birth by any chance?
[AGENT][NEUTRAL] Yes, what is the patient's name, date of birth?
[CUSTOMER][NEUTRAL] Yeah, the first name is [PII]. That's [PII] A.
[CUSTOMER][NEUTRAL] MM
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, and the last name?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Uh last name is [PII], [PII]
[AGENT][NEUTRAL] OK, and the date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and [PII], do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] Sure. That's [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]. Uh, no extension direct line.
[AGENT][NEUTRAL] OK, thank you. Hold one moment please.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] So.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] If you wanna call that, yeah.
[AGENT][NEUTRAL] OK, and [PII], you said that you're calling for claim status, correct?
[CUSTOMER][NEUTRAL] It
[CUSTOMER][POSITIVE] Yeah, I do.
[AGENT][NEUTRAL] OK, and what was the data service and amount of the charge?
[CUSTOMER][NEUTRAL] Uh, the date of service I have here, that's [PII].
[CUSTOMER][NEUTRAL] And the bill amount for [PII], that is going to be $546 even.
[AGENT][NEUTRAL] OK, thank you. And this is for medical, correct?
[CUSTOMER][POSITIVE] Yeah, correct.
[AGENT][POSITIVE] OK, thank you so much. Give me one moment, please.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, I do not show any claims have been received. Can you verify the mailing address the claim was submitted to?
[CUSTOMER][NEUTRAL] Oh yeah.
[CUSTOMER][NEUTRAL] Say was submitted to the mailing address I have here.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yeah, I do have, we have submitted it, sir.
[CUSTOMER][NEUTRAL] Uh, your ID.
[CUSTOMER][NEUTRAL] Uh 58102. That's the payer ID we have submitted it to.
[AGENT][NEUTRAL] OK. Well, we have not received the claim, and that's not our pay ID. If you like, I can give you the mailing address and or fax number where you can submit that claim.
[CUSTOMER][NEUTRAL] Sure. Mailing address.
[AGENT][NEUTRAL] OK, it's [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Just give me a moment. Um, let me verify.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] In our system whether we have it or not, otherwise I I will it.
[CUSTOMER][NEUTRAL] One
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] And uh
[CUSTOMER][NEUTRAL] Uh, [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK. Uh, can I get the fax number?
[AGENT][NEUTRAL] Sure, it's [PII].
[CUSTOMER][NEUTRAL] Uh, is there any specific attention?
[AGENT][NEUTRAL] Just claims department.
[CUSTOMER][NEUTRAL] OK. And what's the timely filing limit?
[AGENT][NEGATIVE] Uh, there is no timely filing.
[CUSTOMER][NEUTRAL] Uh, OK. And the policy is active for the data service?
[AGENT][NEUTRAL] Uh, show an effective date of [PII] and the policy is active.
[CUSTOMER][NEUTRAL] And is, is it the member ID D4330301740?
[AGENT][NEUTRAL] Uh, not with our company. When you're ready, I can give you that policy number.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] It is 228-707-2.
[CUSTOMER][NEUTRAL] 228-707-22287072.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Can I also get the call reference number?
[AGENT][NEUTRAL] Uh, we do not give call reference numbers. If you like, you may use my name in today's date.
[CUSTOMER][NEUTRAL] OK. Uh, so you guys don't use, uh, payer IDs for claims?
[AGENT][NEUTRAL] Our pay ID is 60801.
[CUSTOMER][NEUTRAL] I mean,
[CUSTOMER][NEUTRAL] 60801.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And uh
[CUSTOMER][NEUTRAL] One last question. The company and the insurance, uh, your company name?
[AGENT][NEUTRAL] APL.
[CUSTOMER][NEUTRAL] APL.
[CUSTOMER][NEUTRAL] Uh, what is your good name?
[AGENT][NEUTRAL] My name is [PII], last initial [PII].
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] 6
[CUSTOMER][POSITIVE] Thank you so much, [PII]. Uh, I hope you have a beautiful day and uh I'll definitely go ahead. And under the uh fax, so you just need the claim form, correct?
[AGENT][NEUTRAL] Yes, we need the claim.
[CUSTOMER][POSITIVE] OK. Thank you so much for that, [PII]. I'll
[CUSTOMER][NEUTRAL] Yes, I will go ahead and send the.
[CUSTOMER][NEUTRAL] Uh, as soon as possible.
[AGENT][POSITIVE] OK, uh thank you for calling APL [PII]. Have a great day.
[CUSTOMER][NEUTRAL] You too. Bye.
[AGENT][NEUTRAL] Bye.