AccountId: 011433970860
ContactId: 65d67cc1-f8db-4c3c-8633-c4c737922e8e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 380029 ms
Total Talk Time (AGENT): 111242 ms
Total Talk Time (CUSTOMER): 184253 ms
Interruptions: 2
Overall Sentiment: AGENT=0.9, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/24/65d67cc1-f8db-4c3c-8633-c4c737922e8e_20250124T17:18_UTC.wav
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[CUSTOMER][NEUTRAL] Oh
[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Uh yes. Uh, hi, [PII]. This is [PII] from provider's office. And this call is for claim status. Can you assist me on this?
[AGENT][POSITIVE] Sure, I'll be more than happy to assist you with the claim status and [PII], how many claims do you have in total today?
[CUSTOMER][NEUTRAL] 32.
[AGENT][NEUTRAL] OK, may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes, it's [PII] and [PII] is the extension.
[AGENT][NEUTRAL] Thank you for that. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] Uh, yes. Member policy number is 02505763M as in Mary, L as in Lima, number 8.
[AGENT][NEUTRAL] Thank you for that. And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] It's [PII] [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And are both claims for um [PII]?
[CUSTOMER][NEUTRAL] Yeah, this is for the date of service [PII]. So, uh, on the same date of service, I have two claims.
[AGENT][NEUTRAL] OK, what are the two total bills?
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] The total bill amount for both the claim?
[AGENT][NEUTRAL] You said you have two different amounts for the data service [PII], right?
[CUSTOMER][NEUTRAL] Yes, yes. Yes. Uh, so the uh.
[AGENT][NEUTRAL] May I have both of the amounts?
[CUSTOMER][NEUTRAL] Yes, $620 even and $150 even.
[AGENT][NEUTRAL] $620 and $150?
[CUSTOMER][NEUTRAL] Because
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] So I'm actually not showing any claims on file for [PII] for [PII].
[CUSTOMER][NEUTRAL] OK. And uh for both the amount, any other amount?
[AGENT][NEUTRAL] There's no claim on on file for that date at all, correct.
[CUSTOMER][NEUTRAL] Any claim for the details service?
[CUSTOMER][NEUTRAL] OK. And uh can you confirm me the uh mailing address for claim submission?
[AGENT][NEUTRAL] Sure, our mailing address is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] The zip code is [PII].
[CUSTOMER][NEUTRAL] Just give me a moment.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh yes. So, I'll repeat the mailing address, just correct me if I go wrong. It's [PII].
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] Uh, yes, just get a moment.
[CUSTOMER][NEUTRAL] Yes. Uh, actually, for this, um, uh, you can also, uh, uh, can we submit this claim electronically or it's, uh, only at the mailing address you gave me?
[AGENT][NEUTRAL] Yes, we have a payer ID as well. That's 60801.
[AGENT][NEUTRAL] And it can be sent by fax as well.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] And uh for the same patient, usually how many days it takes to uh get uh you guys receive this if we mail on [PII]. Because sometimes insurance uh in the system, it takes around 30 days or any usual time you
[AGENT][NEUTRAL] Um, there's no time, but I mean, that's almost 2 months. I would definitely resend it.
[CUSTOMER][NEUTRAL] OK. And for the same patient, I have another date of service. So, can you also check for that?
[AGENT][NEUTRAL] Yes, what is that data service?
[CUSTOMER][NEUTRAL] Yes. The date of service I have is [PII] and $450 even total charge amount.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, I'm also not showing any claims on file for [PII].
[CUSTOMER][NEUTRAL] OK. And uh patient [PII] is eligible with you guys on the date of service as a secondary because we have already got the payment from primary and we have, we are sending this as a secondary with primary UB. So, uh, can you confirm if patient is a?
[AGENT][POSITIVE] Yes, she was eligible.
[AGENT][NEUTRAL] The policy has been, go ahead.
[CUSTOMER][NEUTRAL] OK. Mhm.
[CUSTOMER][NEUTRAL] Uh, can I also get the date from which date patient is active and the term date?
[AGENT][NEUTRAL] Yes, that's what I was trying to give you. So the policy has been active since [PII].
[AGENT][NEUTRAL] So it was active on the data service.
[CUSTOMER][NEUTRAL] OK, got you. And you can help me with the call reference number and your name now.
[AGENT][NEUTRAL] There's no call reference number, but you can use my name, [PII] name is [PII].
[CUSTOMER][POSITIVE] OK. Thank you so much, [PII], for your help. You have a wonderful day.
[AGENT][POSITIVE] You also, and thanks for calling APL. Bye-bye.
[CUSTOMER][POSITIVE] Bye-bye. Take care.
[CUSTOMER][NEUTRAL] Bye bye.