AccountId: 011433970860
ContactId: 6002b63c-cd90-4eb4-8b66-e98b5985fcf2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 344649 ms
Total Talk Time (AGENT): 95269 ms
Total Talk Time (CUSTOMER): 148779 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/30/6002b63c-cd90-4eb4-8b66-e98b5985fcf2_20250530T17:34_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] For calling APL, my name is [PII]. How can I assist you today?
[CUSTOMER][NEUTRAL] Hi, I'm [PII] calling from provider's office, checking for the claim status.
[AGENT][POSITIVE] I'd be happy to assist with claim status today, [PII], if I can get a good call back number for you.
[CUSTOMER][NEUTRAL] Yeah, [PII].
[AGENT][NEUTRAL] And what is the policy number?
[CUSTOMER][NEUTRAL] Yeah, the policy number is 02265946.
[AGENT][NEUTRAL] Patient's name and date of birth.
[CUSTOMER][NEUTRAL] The first name is [PII] and the last name is [PII], and the date of birth was [PII].
[AGENT][NEUTRAL] And what is the date of service?
[CUSTOMER][NEUTRAL] Yeah, the date of service was [PII] with the total charge amount was.
[CUSTOMER][NEUTRAL] $320 even.
[AGENT][NEUTRAL] And what's your tax ID?
[CUSTOMER][NEUTRAL] Yeah, the tax IDs and give me one moment.
[CUSTOMER][NEUTRAL] Waterloo
[CUSTOMER][NEUTRAL] Yeah, the tax ID is [PII].
[AGENT][NEUTRAL] I'm not sure we have that claim on file.
[CUSTOMER][NEUTRAL] I'm seeing we are submitted through electronically on [PII].
[CUSTOMER][NEUTRAL] [PII]. Just to confirm that there is no claim on file?
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] OK, can you give me the when was special effective for this one?
[AGENT][NEUTRAL] Policy was effective on [PII]. Policy term on [PII].
[CUSTOMER][NEUTRAL] OK, [PII], and tamped on.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Could you repeat that terminated?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, [PII] and still active for the date of service as a primary, right?
[AGENT][NEUTRAL] Well, we're not the primary, we're the secondary.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. You are the secondary.
[CUSTOMER][NEUTRAL] Give me one moment.
[CUSTOMER][NEUTRAL] Who is the primary for this one?
[AGENT][NEUTRAL] Um, that you'll have to ask the patient.
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] You'll have to get that information from the patient.
[CUSTOMER][NEUTRAL] I don't, uh.
[CUSTOMER][NEUTRAL] Uh, the primary information.
[CUSTOMER][NEUTRAL] On the the number. OK, what is the patient plan type like HMO or PPO?
[AGENT][NEUTRAL] That's a question for their primary we're the secondary.
[CUSTOMER][NEUTRAL] OK, I'm asking the secondary plan type like HMO PPO.
[AGENT][NEUTRAL] It's a gap. It's not a HMO and PPO can only be for the major medical for their primary. That is a question for their primary insurance.
[CUSTOMER][NEUTRAL] OK, it's like a patient plan type was gap, right? GAP.
[AGENT][NEUTRAL] Yes, with us, we're their gap insurance.
[CUSTOMER][NEUTRAL] OK, yeah, and uh do you have the group number for this number?
[AGENT][NEUTRAL] Group number is.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] 22517.
[CUSTOMER][NEUTRAL] 22517. And can you give me the claim mailing address for submitting the claim?
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And that's in [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And the zip code is [PII].
[CUSTOMER][NEUTRAL] Oh OK
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And the zip code is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, give me one moment.
[CUSTOMER][NEUTRAL] [PII], right?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] OK. And what is the payer ID for submitting the claim?
[AGENT][NEUTRAL] 60801.
[CUSTOMER][NEUTRAL] 60801 and what is the time limit for submitting the claim?
[AGENT][NEGATIVE] There is no timely filing.
[CUSTOMER][NEGATIVE] No timely file.
[CUSTOMER][NEUTRAL] OK, and what is that? Can you give me the call reference for the call reference?
[AGENT][NEUTRAL] Reference is just my name [PII] last initial [PII], and the date and time of the call. Was there anything else I could assist with today?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Do you have any fax number for submitting the claim?
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And attention to whom?
[AGENT][NEUTRAL] Claims department.
[CUSTOMER][POSITIVE] department. OK, thank you so much. Have a great day. Bye bye. Take care.
[AGENT][POSITIVE] Thank you for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] You too bye.