AccountId: 011433970860
ContactId: 61c4d5b2-251c-44d5-a7b6-ad06cb86c69e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 357920 ms
Total Talk Time (AGENT): 140963 ms
Total Talk Time (CUSTOMER): 124635 ms
Interruptions: 1
Overall Sentiment: AGENT=0.8, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/19/61c4d5b2-251c-44d5-a7b6-ad06cb86c69e_20250519T15:34_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Are you able to help with claims?
[AGENT][POSITIVE] Yes, I can assist you with claims.
[AGENT][NEUTRAL] May I have your name?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It's [PII]
[AGENT][NEUTRAL] Ms [PII], you're calling from provider's office or this is your personal policy?
[CUSTOMER][NEUTRAL] Provider.
[AGENT][NEUTRAL] OK, may I have the name of the facility you're calling from?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK. And may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. May I have the patient's policy number?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 02455568.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Date of birth [PII].
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Can you verify the date of birth one more time for me, Miss [PII]?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. All right, and what is the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] Uh, the first one is [PII].
[AGENT][NEUTRAL] Mm. And how much is the total?
[CUSTOMER][NEUTRAL] For 2160, 2160. This is a secondary claim. Do you have it on file?
[AGENT][NEUTRAL] OK, let me check and see. Let me pull the new policy, one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Is this for the facility charges, Ms. [PII], or is it for procedures?
[CUSTOMER][NEUTRAL] Uh, procedure code is 97153 and there's a 97156 on the claim as well.
[AGENT][NEUTRAL] OK, so not.
[AGENT][NEUTRAL] It doesn't look like we have received that claim. Um, is this like separate days or is it one single claim for?
[CUSTOMER][NEUTRAL] And so,
[CUSTOMER][NEUTRAL] One single claim, hold on, let me see what was uh.
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Uh, it was sent by fax. Can you check, uh, fax it on [PII] to [PII].
[AGENT][NEUTRAL] OK, it's not gonna be imaged on the same date because it takes 24 to 48 hours to be imaged, um.
[CUSTOMER][NEUTRAL] OK, well, I'm, I'm giving you the date, so, you know, around that time.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me.
[CUSTOMER][NEUTRAL] Got a confirmation that it was received.
[AGENT][NEUTRAL] Let me see if I have.
[AGENT][NEUTRAL] Bear with me. I'm just gonna go ahead and check the range of days just for that day. I, I didn't see anything for the [PII]. OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I can possibly try to just resend it if it's not there.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] You probably need the new policy number, but let me double check, OK?
[CUSTOMER][NEUTRAL] OK, well, let me see what number is on there.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, it's the same one, the policy number I gave you.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, I can resend it.
[AGENT][NEUTRAL] Mm, OK.
[AGENT][NEUTRAL] Yeah, I don't see that procedure code at all.
[CUSTOMER][NEUTRAL] I resend it, but what, what do you mean the new policy number?
[AGENT][NEUTRAL] Yeah, they have a new number. The one you gave me was an old number.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, but it was active at the time of service, right?
[AGENT][NEUTRAL] No, uh, no, it's a, it's a different number.
[AGENT][NEUTRAL] So let me go ahead and give you the correct policy number.
[CUSTOMER][NEUTRAL] One moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Sorry, one moment.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Go ahead.
[AGENT][NEUTRAL] OK, the correct policy number is 02.
[AGENT][NEUTRAL] 58
[AGENT][NEUTRAL] 347 2.
[CUSTOMER][NEUTRAL] OK, and may I ask when did that change?
[AGENT][NEUTRAL] Effective date [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, uh, can I get a call reference number, please? I'm sorry, what was your name again?
[AGENT][NEUTRAL] We
[AGENT][NEUTRAL] My name is [PII], and we don't have reference numbers. You can use my name in today's date if you would like, Ms. [PII]. Is there anything else I'm gonna help you with today?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No, that'll be all.
[AGENT][POSITIVE] All right, well thank you for calling APL. Have a good day, Ms. [PII].
[CUSTOMER][NEUTRAL] You too. Bye-bye.
[AGENT][POSITIVE] Thank you, bye bye.