AccountId: 011433970860
ContactId: 66fadb15-dd35-48cd-9aac-05c92450f1ee
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 239369 ms
Total Talk Time (AGENT): 113349 ms
Total Talk Time (CUSTOMER): 89277 ms
Interruptions: 1
Overall Sentiment: AGENT=1.9, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/07/66fadb15-dd35-48cd-9aac-05c92450f1ee_20250107T15:49_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yeah, hi, it's [PII]. You're calling from provider office to check on the claim status.
[AGENT][POSITIVE] It would be my pleasure to assist you. Can I ask your name to spell your name?
[CUSTOMER][NEUTRAL] Oh yeah, it's [PII] Last initial, it's [PII].
[AGENT][NEUTRAL] Thank you, [PII]. And what is the patient's policy number?
[CUSTOMER][NEUTRAL] Oh yeah. It's 01845790. M as in Mary, L as in Lima, number 8.
[AGENT][POSITIVE] All right, thank you.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And [PII], what is the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] Oh yeah. It's [PII] Date of birth is [PII].
[AGENT][POSITIVE] Alright, thank you, and if you were needing claim status as I understand, and it would be my pleasure to assist you. Do you have a claim number or date of service?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I do have the date of service. Uh, it is September 24, 2024, and the charge amount is $724 and even.
[AGENT][NEUTRAL] Bear with me just one second, my computer is slowed down. I apologize.
[AGENT][NEUTRAL] It is [PII]?
[CUSTOMER][NEUTRAL] It's OK.
[CUSTOMER][POSITIVE] Yeah, that's correct.
[CUSTOMER][NEUTRAL] What
[CUSTOMER][NEUTRAL] That
[AGENT][NEUTRAL] I am checking for that data service [PII]. I do not have a claim on file for [PII].
[CUSTOMER][NEUTRAL] OK, could you verify the like a mailing address, is it correct or wrong? Uh, it's [PII].
[AGENT][NEUTRAL] That is, that is no longer a valid claim submission address.
[CUSTOMER][NEUTRAL] Is it correct?
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] And I can give you that. What is a good callback number and in case we get disconnected I can get right back to you?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Sure. Uh, it's [PII].
[AGENT][POSITIVE] Thank you. I can give you our correct mailing address.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Correct mailing address is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And the zip code is [PII]. Now that also can be faxed directly to our claims department, the claim form and the primary EOB.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK. What will be the fax number?
[AGENT][NEUTRAL] Fax number to our claims department is [PII].
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, and what will be the time frame for this one?
[AGENT][NEGATIVE] There's no timely filing.
[CUSTOMER][NEUTRAL] OK, next time, sure. And does the member is active for this state of service?
[AGENT][NEUTRAL] Yes, ma'am. The effective date is [PII], and the policy is active.
[CUSTOMER][POSITIVE] OK, sure. Thank you so much. And uh
[CUSTOMER][NEUTRAL] What will be the call reference for this one?
[AGENT][NEUTRAL] The call reference number is my name and today's date, and I spell my name [PII].
[AGENT][POSITIVE] It was a pleasure to assist you with that claim status. Anything else I can help you with, [PII]?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Uh, no, nothing. Thank you so much for your assistance. Have a nice day. Bye-bye.
[AGENT][POSITIVE] I hope you have a wonderful day as well and then thank you for calling APL. Take care. Bye bye.
[CUSTOMER][NEUTRAL] Yeah