AccountId: 011433970860
ContactId: 65d103a9-3e70-4a75-8f27-c6f37c52395c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 454010 ms
Total Talk Time (AGENT): 78140 ms
Total Talk Time (CUSTOMER): 110011 ms
Interruptions: 0
Overall Sentiment: AGENT=-0.2, CUSTOMER=1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/27/65d103a9-3e70-4a75-8f27-c6f37c52395c_20250527T19:51_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hello. I need the claim information. Can you verify that?
[AGENT][NEUTRAL] I can check on a claim for you. What's the patient's policy number, please?
[CUSTOMER][NEUTRAL] Yeah, patient policies.
[CUSTOMER][NEUTRAL] It's 182-315-0.
[AGENT][NEUTRAL] May I have your first name please for documentation?
[CUSTOMER][NEUTRAL] Yeah, my name is [PII] and the last [PII] is [PII]. Can you spell your name, please?
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] What's the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] Patient name is
[CUSTOMER][NEUTRAL] [PII] [PII]
[AGENT][NEUTRAL] And date of service?
[CUSTOMER][NEUTRAL] Yeah, the data service is 516-2024.
[AGENT][NEUTRAL] In the build out?
[CUSTOMER][NEUTRAL] It's $336 even.
[AGENT][NEUTRAL] There's no claim on file for that date of service.
[CUSTOMER][NEUTRAL] OK. It is a crossover claim from the Aetna. Can you check once?
[AGENT][NEUTRAL] I don't show any claims on file. Member doesn't have an active plan with us for the date of service either.
[CUSTOMER][NEUTRAL] When are the effective dates of the patient?
[AGENT][NEUTRAL] Effective date was [PII]. The plan terminated as of [PII].
[CUSTOMER][NEUTRAL] Is this the latest affected dates?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Uh, thank you. Uh, may I know the, uh, this patient have any another insurance?
[AGENT][NEUTRAL] Not with us at this time, no.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, may I place the call on hold for a moment? I will make it fast.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] Yeah, thank you for patience and sorry for making you on a hold.
[CUSTOMER][NEUTRAL] Yeah, I got the required information for this patient. Um,
[CUSTOMER][NEUTRAL] I do have another claim for the different patient. Can you verify that?
[AGENT][NEUTRAL] Uh, let me just notate this and I can check another one moment.
[CUSTOMER][NEUTRAL] Uh, before that, uh, is there, uh, when was the covers updated, you have the date?
[AGENT][NEUTRAL] When was what updated?
[CUSTOMER][NEUTRAL] CO, it's coordination of benefits.
[AGENT][NEGATIVE] Oh, there is no coordination of benefits.
[CUSTOMER][POSITIVE] OK, thank you for the information. Yeah.
[AGENT][NEUTRAL] What's the next member ID?
[CUSTOMER][NEUTRAL] Yeah, text number ID is
[CUSTOMER][NEUTRAL] 60801.
[AGENT][NEUTRAL] That's our payer ID, not a policy number.
[CUSTOMER][NEUTRAL] Sorry.
[CUSTOMER][NEUTRAL] It was
[CUSTOMER][NEUTRAL] What?
[CUSTOMER][NEUTRAL] A moment. Just checking.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Oh yes
[CUSTOMER][NEUTRAL] OK. Uh, sorry, we didn't have that information. It's just mention that. Uh, can, can I get the mailing address?
[AGENT][NEUTRAL] For claims?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] The claim's mailing address is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] May I know the TFL to submit the claim?
[AGENT][NEUTRAL] I'm sorry, what was that again?
[CUSTOMER][NEUTRAL] timely filing uh for the initial submission of the claim.
[AGENT][NEGATIVE] No timely filing.
[CUSTOMER][NEUTRAL] Is there any payer ID or 6081, right?
[AGENT][NEUTRAL] 60801.
[CUSTOMER][POSITIVE] Yeah, thank you.
[CUSTOMER][NEUTRAL] A moment. Uh.
[AGENT][NEUTRAL] Do you have another member ID?
[CUSTOMER][NEUTRAL] No, I didn't have. I'm just checking for the member details, but I can pull any member details.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Yeah, thank you for the information. Can I get the call reference number?
[AGENT][NEUTRAL] Call references my name with today's date.
[CUSTOMER][POSITIVE] Thank you. Thank you for the information. Have a great day. Bye-bye.
[AGENT][NEUTRAL] You too bye bye.