AccountId: 011433970860
ContactId: 69c9ed04-f41e-407b-a92b-c0b22775fe39
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 328309 ms
Total Talk Time (AGENT): 154085 ms
Total Talk Time (CUSTOMER): 89232 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/23/69c9ed04-f41e-407b-a92b-c0b22775fe39_20250123T13:02_UTC.wav
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[AGENT][NEUTRAL] And thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], I'm calling from the provider's office checking claim status.
[AGENT][NEUTRAL] OK, you're needing to check claim status, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Yes, ma'am. I can help you with that. And who am I speaking with, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you. And [PII], what is a good callback number for you?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and [PII], how many claims do you have to check status on today?
[CUSTOMER][NEGATIVE] There's 9 of them that we've billed you guys um in June and we've not received anything.
[AGENT][NEUTRAL] OK, is it for the same member or 9 different patients?
[CUSTOMER][NEUTRAL] No, it's the same patient, just the same different dates of service.
[AGENT][NEUTRAL] Yes, ma'am. I can help you. And what is um the member's policy number, [PII]?
[CUSTOMER][NEUTRAL] That's gonna be um 02282219.
[AGENT][NEUTRAL] OK, thank you. Give me a couple moments to get the member's information pulled up.
[AGENT][NEUTRAL] And any information that I do provide for you today, [PII], would be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth?
[CUSTOMER][NEUTRAL] [PII] and the last name is [PII] [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, and [PII], you will use my name along with today's date as your call reference number for all of them and also any information that's provided on any of the claims would be a verification of benefits and not a guarantee of payment. So what is your first day of service and total bill amount?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII] for 300.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] OK, we do not have a claim on file for him for that data service.
[CUSTOMER][NEUTRAL] And that should we build the paper claim so that was [PII], um.
[AGENT][NEUTRAL] No, ma'am.
[AGENT][NEUTRAL] That's a very old address.
[CUSTOMER][NEUTRAL] OK, that's
[CUSTOMER][NEUTRAL] All right.
[AGENT][NEUTRAL] It used to be at one time our PO box, [PII], but that's, yeah, it hasn't been our PO box in quite some time.
[CUSTOMER][NEUTRAL] Can I fax these or do they have to be mailed?
[AGENT][NEUTRAL] No, you may fax them. We will also have to have the primary insurance company's explanation of benefits.
[AGENT][NEUTRAL] For each of them as well and then once we do process the claims Denise, you should be able to go to our portal at [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] To check claim status and also to have access to the EOBs for APL.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So if maybe we need to uh maybe we you need to give me, I don't mean to say you need I hate when people say that if you could give me the correct address and I can have this corrected for this insurance as well and then the fax.
[AGENT][POSITIVE] Absolutely.
[AGENT][NEUTRAL] Sure, the claims PO box is 248,950.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] That's [PII], [PII].
[CUSTOMER][NEUTRAL] [PII], [PII], OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The date, I'm sorry, the date. The zip code is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And our claims fax number, our secured fax line is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Perfect. All right, well.
[AGENT][NEUTRAL] And this policy said that you know is effective from [PII].
[CUSTOMER][NEUTRAL] What's the end date of the [PII]?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] OK, yeah, these are like obviously April and May, so we're good, um, do we have any in no, then they stop treating in September. OK, no, perfect. Alright, well thank you so much for your help.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Well, absolutely. You are very welcome. So, is there anything else at the moment I could help you with?
[CUSTOMER][NEGATIVE] No, there's no point going over anymore because obviously we've billed them to the wrong place so no we're good.
[AGENT][POSITIVE] OK, [PII]. Well then, um thank you again for calling APL and I hope that you have a wonderful day.
[CUSTOMER][POSITIVE] Thanks you as well bye bye.
[AGENT][POSITIVE] Yes ma'am thank you bye bye.