AccountId: 011433970860
ContactId: 689e5888-8196-45da-ae29-ff0692cb61b7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 254220 ms
Total Talk Time (AGENT): 85842 ms
Total Talk Time (CUSTOMER): 79947 ms
Interruptions: 0
Overall Sentiment: AGENT=-0.7, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/25/689e5888-8196-45da-ae29-ff0692cb61b7_20250625T20:00_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling for the provider's office. And this call is made to get additional information on a claim that has been denied. Please be informed that this call will be recorded and monitored for quality and training purposes.
[AGENT][NEUTRAL] I'm sure, [PII], I can assist you with claim status first, could I get a good callback number just in case we're disconnected?
[CUSTOMER][NEUTRAL] Yeah, sure. It is [PII]. It is the direct line.
[AGENT][NEUTRAL] OK. Thank you. Now, I need the policy number, please.
[CUSTOMER][NEUTRAL] Uh 60801.
[AGENT][NEUTRAL] No, that's our payer ID. I need the member's policy number.
[CUSTOMER][NEUTRAL] Member ID is 02618570.
[AGENT][NEUTRAL] And please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] First name is [PII], last name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you. Now I need the date of service and bill charges on the claim.
[CUSTOMER][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Data services on [PII] for
[CUSTOMER][NEUTRAL] $228 even.
[CUSTOMER][NEGATIVE] It is rejected as we are unable to locate the policy for this member.
[AGENT][NEUTRAL] OK. I was actually able to find the policy, but that claim is not on file.
[CUSTOMER][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] OK. The correct member ID is 02618570, right?
[AGENT][NEUTRAL] Yes, sir. That's the correct member ID.
[CUSTOMER][NEUTRAL] Thank you. And can I have the patient policy with you on term D?
[AGENT][NEUTRAL] Yes, one moment and just let me advise you that verification of coverage does not guarantee payment of claims. One moment.
[AGENT][NEUTRAL] OK. The effective date on this policy was
[AGENT][NEUTRAL] Um, [PII] and the policy is still active.
[CUSTOMER][NEUTRAL] Can I have the mailing address to submit the claim?
[AGENT][NEUTRAL] Um, yes, the mailing address to submit claims, um, is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And that's in [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And the zip code is [PII].
[CUSTOMER][NEUTRAL] Can I have the payer ID?
[AGENT][NEUTRAL] Yes, the payer ID is 60801.
[CUSTOMER][NEUTRAL] And the timely filing limit?
[AGENT][NEGATIVE] There's no timely filing limit.
[CUSTOMER][NEUTRAL] OK, there is no timely filing limit, right?
[AGENT][NEGATIVE] Right, there's no timely filing limit.
[CUSTOMER][NEUTRAL] Thank you. Can I have the call reference number?
[AGENT][NEUTRAL] Yes, for the reference number, you can use my name and today's date. My name is [PII] um it's spelled [PII] E. My last initial is [PII] and today's date. Is there anything else I can assist you with?
[CUSTOMER][POSITIVE] Yeah, thank you, [PII]. That's all I have for the day. Have a great day. Bye-bye.
[AGENT][NEUTRAL] You do the same, [PII]. Thank you for calling APL bye.