AccountId: 011433970860
ContactId: 6275f6e3-51dd-4551-a224-254e88424030
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 363250 ms
Total Talk Time (AGENT): 128858 ms
Total Talk Time (CUSTOMER): 126225 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/09/6275f6e3-51dd-4551-a224-254e88424030_20250109T14:37_UTC.wav
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[AGENT][NEUTRAL] For calling APL, this is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from provider office. Do you know the claim status?
[AGENT][NEUTRAL] Sure, I can assist you with that. Could you provide me with the spelling of your name and a callback number?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] And the spelling of your name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] You said [PII]?
[CUSTOMER][NEUTRAL] Yes, it's [PII], initial last name [PII].
[AGENT][NEUTRAL] [PII], can I have the policy number of the member that you're inquiring claims checking claim status of?
[CUSTOMER][NEUTRAL] Yeah, sure.
[CUSTOMER][NEUTRAL] Yes, the member policy number is 2, it starts with 02331177. M for Mike.
[CUSTOMER][NEUTRAL] L for Leo, 8.
[AGENT][POSITIVE] Thank you, you could verify the patient's name and date of birth, and I'll be able to assist you.
[CUSTOMER][NEUTRAL] Yes, the patient's name is [PII] and the date of birth [PII].
[AGENT][NEUTRAL] And what is the date of service that you're inquiring for [PII]?
[CUSTOMER][NEUTRAL] Yes, just a second, please.
[CUSTOMER][NEUTRAL] The date of service is [PII].
[AGENT][NEUTRAL] What is your procedure called?
[CUSTOMER][NEUTRAL] Uh, you know the claim status?
[AGENT][NEUTRAL] The procedure code of the claim that you're inquiring of claim status requesting claim status for?
[CUSTOMER][NEUTRAL] Uh, to know whether the claim has been denied or paid.
[AGENT][NEUTRAL] No, what is the procedure code for the date of service that you're inquiring claim status for? Yes, the the the CPT code.
[CUSTOMER][NEUTRAL] So the zip code.
[CUSTOMER][NEUTRAL] 000.
[CUSTOMER][NEUTRAL] OK, then, then it's [PII].
[AGENT][NEUTRAL] And what is your
[AGENT][NEUTRAL] Bill amount.
[CUSTOMER][NEUTRAL] Uh, the bill amount is
[CUSTOMER][NEUTRAL] $290 290 dollars.
[AGENT][NEUTRAL] Um, is this for a facility charge or is this for?
[AGENT][NEUTRAL] Oh,
[AGENT][NEUTRAL] Is it a facility charge or is this for a professional charge? What is this for? Because I'm not showing that procedure code or the bill amount.
[CUSTOMER][POSITIVE] Actually, the BCBS has forwarded the claim to your insurance by checking out the secondary, and we just forwarded the uh patient responsibility to you.
[AGENT][NEUTRAL] And what was the patient's responsibility?
[CUSTOMER][NEUTRAL] It's $77.95.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] I
[AGENT][NEUTRAL] So it looks like we did receive this claim [PII] and it was processed [PII], however, it was submitted by the insured, so I can't give you any information on it.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So I'm not seeing your claim on file. I only see that claim that was submitted by the insured but not from the the provider itself.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, in such a case, can we refer a client?
[AGENT][NEUTRAL] Yeah, you can submit a claim.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. Can I know your good name, please?
[AGENT][NEUTRAL] Did you know what, [PII]?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Could you repeat what you just asked me?
[CUSTOMER][NEUTRAL] Uh, can I know your name?
[AGENT][NEUTRAL] My name is [PII]
[CUSTOMER][NEUTRAL] OK. Uh, in such case, can we refund the claim to you?
[AGENT][NEUTRAL] Yeah, you can submit a claim, you can submit a claim, but I'm not sure if it's gonna be paid, but you can submit a claim.
[CUSTOMER][NEUTRAL] Again.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. Sure.
[CUSTOMER][NEUTRAL] Uh, can you please help me with the call reference number and your time filing limit?
[AGENT][NEUTRAL] We don't provide reference numbers [PII], however, you can use my name in today's date as a reference, and there is no timely filing.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Is there anything else that I can assist you with today?
[CUSTOMER][NEUTRAL] Mm, OK, can I get the PO box address and everything?
[AGENT][NEUTRAL] So the claims address to submit a claim would be addressed to American Public Life.
[AGENT][NEUTRAL] PO box?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 248,950.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII]. This PO [PII] 248,950, [PII]. Is there anything else that I can assist you with today?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes. Uh, can you please help me with the payer ID?
[AGENT][NEUTRAL] 60801.
[CUSTOMER][POSITIVE] OK. Uh, then, uh, thank you. Have a wonderful day. Go ahead.
[AGENT][POSITIVE] Thanks for calling APL. Have a great day bye bye.
[CUSTOMER][POSITIVE] Yes. Thank you. Bye-bye.