AccountId: 011433970860
ContactId: 5e80b695-ae56-4331-b0e4-8f3eef09814b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1809589 ms
Total Talk Time (AGENT): 286794 ms
Total Talk Time (CUSTOMER): 261030 ms
Interruptions: 0
Overall Sentiment: AGENT=-0.3, CUSTOMER=-0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/23/5e80b695-ae56-4331-b0e4-8f3eef09814b_20250623T21:11_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from provider's office checking on client status.
[AGENT][NEUTRAL] Hi [PII], I can help you with claim status. Do you have a good callback number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Excuse me.
[AGENT][NEUTRAL] And do you have the policy number for the patient?
[AGENT][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] The policy number for the patient?
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] 02474068
[AGENT][NEUTRAL] Hello.
[AGENT][NEUTRAL] OK, 0247.
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] Can you repeat the number again, please?
[CUSTOMER][NEUTRAL] 02474068
[AGENT][NEUTRAL] The patient name and date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] Data service and bill charges.
[CUSTOMER][NEUTRAL] 1219 2024 $184 even.
[AGENT][NEUTRAL] OK, uh, claim was received 12725. Process 128 25.
[AGENT][NEUTRAL] Office visits are not covered under the policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Your name, ma'am?
[AGENT][NEUTRAL] My name is [PII]. First initial and last name, [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] And the reference is my name in today's date.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Anything else I can help with?
[CUSTOMER][NEUTRAL] Checking on claim status.
[AGENT][NEUTRAL] OK, are you wanting to check a different one?
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] Are you wanting to check a different claim?
[CUSTOMER][NEUTRAL] No, same plan.
[AGENT][NEUTRAL] OK, what was your question?
[CUSTOMER][NEUTRAL] What is the status of this plan?
[AGENT][NEUTRAL] Oh, OK, OK, you didn't hear what I, I just read the status. Hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The claim was received 12725, processed 12825. Office visits are not covered under the policy.
[CUSTOMER][NEUTRAL] Under patient's policy or provider's policy?
[AGENT][NEUTRAL] Patient's policy.
[CUSTOMER][NEUTRAL] Can I be patient for this one?
[AGENT][NEUTRAL] We can't instruct on patient responsibility. This is a supplemental policy.
[CUSTOMER][NEUTRAL] OK, this is an office visit, right? Why don't this patient don't have office visit?
[AGENT][NEGATIVE] It's not covered under their policy.
[CUSTOMER][NEUTRAL] Why it is not covered, ma'am?
[AGENT][NEGATIVE] It's not covered under their policy.
[CUSTOMER][NEUTRAL] Mhm. So it is a patient's policy or provider's policy, ma'am?
[CUSTOMER][NEUTRAL] Can you double check that for me?
[AGENT][NEUTRAL] Yeah, I'd already answered. It's the patient's policy.
[CUSTOMER][NEUTRAL] Connected plan time limit.
[AGENT][NEUTRAL] Sorry?
[CUSTOMER][NEUTRAL] Can I claim time limit.
[AGENT][NEUTRAL] The claim filing limit? There's no timely filing limit?
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] For corrected claim.
[AGENT][NEGATIVE] There's no timely filing limit.
[CUSTOMER][NEUTRAL] So I can submit correct claim whenever I want, right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Shall I go to the next question?
[AGENT][NEUTRAL] OK, the policy number?
[CUSTOMER][NEUTRAL] One moment.
[AGENT][NEUTRAL] You have the policy number?
[CUSTOMER][NEUTRAL] Yeah, ma'am.
[CUSTOMER][NEUTRAL] 1539957
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] asking this
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] It is service and bill charges.
[CUSTOMER][NEUTRAL] That sense.
[CUSTOMER][NEUTRAL] 1216 2024 $125 even.
[AGENT][NEUTRAL] 2 16 2024.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, the policy number you gave me terminated in [PII]. Let me pull up the other policy.
[AGENT][NEUTRAL] OK, are you ready for the claim status?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] It has received 12125 process 12225.
[CUSTOMER][NEUTRAL] 12225.
[AGENT][NEUTRAL] Yes, office visits are not covered under the patient's policy.
[CUSTOMER][NEUTRAL] Can I get a copy of UB through fax for this one?
[AGENT][NEUTRAL] What's your facts?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] 5,854,440.
[CUSTOMER][NEUTRAL] 9493.
[AGENT][NEUTRAL] OK. Do you need any other claim status?
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] Do you have another claim status?
[CUSTOMER][NEUTRAL] Uh yeah, ma'am, one minute.
[CUSTOMER][NEUTRAL] Uh, what is the patient's policy name, ma'am? Can I get the patient's policy name?
[AGENT][NEUTRAL] Patient's policy number 174.
[CUSTOMER][NEUTRAL] Policy name, no, no, policy name.
[AGENT][NEUTRAL] Blink
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] Medlink, M as [PII] in [PII], D as in Delta, L as [PII]
[CUSTOMER][NEUTRAL] No, I'm asking you to.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEGATIVE] It doesn't have more plan with your plan.
[AGENT][NEUTRAL] It's not a, it's neither.
[CUSTOMER][NEUTRAL] It is a HMO or PP.
[AGENT][NEUTRAL] It's, it's neither, it's a supplemental policy.
[CUSTOMER][NEUTRAL] I go to the next station.
[AGENT][NEUTRAL] Yes, the policy number?
[CUSTOMER][NEUTRAL] One minute
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] 02405442.
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] Data service and bill charges.
[CUSTOMER][NEUTRAL] [PII] $195 even.
[AGENT][NEUTRAL] I was received 4-28-25.
[AGENT][NEUTRAL] 429, 25.
[AGENT][NEUTRAL] Um, this is not a covered loss under the plan, not a covered benefit, patient's policy.
[CUSTOMER][NEUTRAL] Cla process to date.
[AGENT][NEUTRAL] You need the dates again?
[AGENT][NEUTRAL] Claim was received 428-25 process 42925.
[CUSTOMER][NEUTRAL] Shall I go to the next station.
[AGENT][NEUTRAL] Uh, yes, one moment.
[AGENT][NEUTRAL] Policy number?
[CUSTOMER][NEUTRAL] One minute.
[CUSTOMER][NEUTRAL] 01792084.
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] of service and bill charges.
[CUSTOMER][NEUTRAL] [PII] $2,296 even.
[AGENT][NEUTRAL] You say 296?
[AGENT][NEUTRAL] Is that right?
[AGENT][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Do you have one of the codes?
[AGENT][NEUTRAL] CPT codes or procedure codes?
[CUSTOMER][NEUTRAL] What is the reason.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] The I.
[AGENT][NEUTRAL] I'm sorry, I, I'm it's hard to hear you. What were you saying? I needed to know what was one of the codes on the, on the claim.
[CUSTOMER][NEUTRAL] 963-72
[AGENT][NEUTRAL] You wanna
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] J. 3145.
[AGENT][NEUTRAL] was received 12125.
[AGENT][NEUTRAL] I must process 12225.
[AGENT][NEUTRAL] The outpatient benefit for the calendar year dollar amount was met.
[CUSTOMER][NEUTRAL] Outpatient visit
[AGENT][NEUTRAL] Sorry?
[CUSTOMER][NEUTRAL] Outpatient visit?
[AGENT][NEUTRAL] The dollar amount payable for the calendar year was met?
[CUSTOMER][NEUTRAL] So I go to the next patient.
[AGENT][NEUTRAL] Yes, hold on one moment. How many more claims do you have?
[CUSTOMER][NEUTRAL] I have 10 more.
[CUSTOMER][NEUTRAL] Oh,
[CUSTOMER][NEUTRAL] to the next patient ID.
[AGENT][NEUTRAL] Yeah, hold on one moment.
[AGENT][NEUTRAL] Policy number?
[CUSTOMER][NEUTRAL] 01986725
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] It is service and bill charges.
[CUSTOMER][NEUTRAL] [PII] $184 even.
[AGENT][NEUTRAL] I don't show that claim on file.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] I have a claim number.
[AGENT][NEUTRAL] OK, what is it?
[CUSTOMER][NEUTRAL] 3556875
[AGENT][NEUTRAL] What's the claim number?
[AGENT][NEUTRAL] It was 3556875.
[AGENT][NEUTRAL] Patience [PII], is that right?
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] OK, it's on a different policy number, so let me, let me get the right policy number pulled up.
[AGENT][NEGATIVE] The one that you gave me was incorrect.
[AGENT][NEUTRAL] Any claim has received 12725. Process 128 25.
[AGENT][NEUTRAL] Office visits are not covered under the patient's policy.
[CUSTOMER][NEUTRAL] Claim process, can you repeat again the claim processed it?
[AGENT][NEUTRAL] 127, 25.
[AGENT][NEUTRAL] Oh it's 128 25.
[CUSTOMER][NEUTRAL] Can I get the copy of your it through fax for this one?
[AGENT][NEUTRAL] OK, the next policy.
[CUSTOMER][NEUTRAL] Give me one minute.
[CUSTOMER][NEUTRAL] One minute.
[CUSTOMER][NEUTRAL] My next policy ID is 01897865.
[AGENT][NEUTRAL] And your name and date of birth?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] D of service and bill charges.
[CUSTOMER][NEUTRAL] [PII] $529 even.
[AGENT][NEUTRAL] You have the claim number for this one?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] I must receive 127 25.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It was processed on 12925.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And what was the total bill charges?
[CUSTOMER][NEUTRAL] $529.
[AGENT][NEUTRAL] OK, uh, actually we don't have this claim. I have a claim for a different dollar amount.
[CUSTOMER][NEUTRAL] You don't have a cell phone.
[AGENT][NEGATIVE] Not for that dollar amount you gave me.
[CUSTOMER][NEUTRAL] What is the client's timely selling limit, ma'am?
[AGENT][NEGATIVE] No timely filing limit.
[CUSTOMER][NEUTRAL] Client's mailing address.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII] City, [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Hm
[CUSTOMER][NEUTRAL] Go home, go home.
[AGENT][NEUTRAL] Sorry?
[CUSTOMER][NEUTRAL] Well.
[CUSTOMER][NEUTRAL] One minute.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And for this patient's information. Uh, what is the patient's policy active date, ma'am?
[AGENT][NEUTRAL] On [PII].
[CUSTOMER][NEUTRAL] [PII], right?
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Yeah the next policy.
[CUSTOMER][NEUTRAL] I know
[CUSTOMER][NEUTRAL] I'm taking patient information. One minute.
[CUSTOMER][NEUTRAL] 2,543,930
[AGENT][NEUTRAL] Is your name and date of birth?
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] State of service and bill charges.
[CUSTOMER][NEUTRAL] [PII] $176 even.
[AGENT][NEUTRAL] Claim was received on [PII].
[AGENT][NEUTRAL] Process [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Services are not covered under the patient's policy.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Can I get the copy of UV through fax for this one?
[AGENT][NEUTRAL] Yes, give me one moment.
[CUSTOMER][NEUTRAL] Can I get the claim number?
[AGENT][NEUTRAL] 354-3309.
[CUSTOMER][NEUTRAL] 354
[AGENT][NEUTRAL] 3309.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And do you have the next policy?
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] One minute.
[CUSTOMER][NEGATIVE] No station.
[AGENT][NEUTRAL] Um, did you have the number?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 01828783.
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] Data service and bill charges.
[CUSTOMER][NEUTRAL] [PII] $131 even.
[AGENT][NEUTRAL] I'm sorry, what was the date?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] $131 even.
[AGENT][NEUTRAL] the claim was received [PII].
[AGENT][NEUTRAL] Oh it's 26-2025.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And services are not covered under the patient's policy?
[CUSTOMER][NEUTRAL] Claim number?
[AGENT][NEUTRAL] 356-045-4
[CUSTOMER][NEUTRAL] 346
[AGENT][NEUTRAL] 356.
[AGENT][NEUTRAL] 0454.
[CUSTOMER][NEUTRAL] 356-045-4, right?
[AGENT][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] Can I get a copy of your fax for this one?
[AGENT][NEUTRAL] OK, the next policy.
[CUSTOMER][NEUTRAL] That sounds like.
[AGENT][POSITIVE] OK, thanks for calling APL. Have a great day.