AccountId: 011433970860
ContactId: 6d29b6c2-8ca3-4c73-b0b5-6778bd3163a5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 506929 ms
Total Talk Time (AGENT): 145095 ms
Total Talk Time (CUSTOMER): 153536 ms
Interruptions: 1
Overall Sentiment: AGENT=0.6, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/25/6d29b6c2-8ca3-4c73-b0b5-6778bd3163a5_20250325T14:18_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII] I'm calling from provider's office. I'm here to know the status of the claim.
[AGENT][NEUTRAL] OK [PII], I can help you with the claim. Can I please get your callback number?
[CUSTOMER][NEUTRAL] Yes, my callback number is [PII].
[AGENT][NEUTRAL] Thank you, sir. And what is the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Yes, the my, uh, the patient name is [PII] and the date of birth is [PII], and the member ID is just provide you.
[CUSTOMER][NEUTRAL] 023
[CUSTOMER][NEUTRAL] 99312.
[AGENT][NEUTRAL] OK, let me pull that up real quick.
[AGENT][NEUTRAL] OK, and um it's for [PII], and what is the date of service and the charge amount?
[CUSTOMER][NEUTRAL] Yes, the date of service is [PII] and the charge amount, let me just provide you, give me a second, please.
[AGENT][NEUTRAL] Yes sir.
[CUSTOMER][NEUTRAL] $3,702 even.
[AGENT][NEUTRAL] OK, and then what is the charges after the primary insurance paid their part?
[CUSTOMER][NEUTRAL] Yes, uh, uh, they paid and the rest balance is $162.72.
[AGENT][NEUTRAL] Thank you, sir. And can you please give me the name of the facility you're calling from, Max?
[CUSTOMER][NEUTRAL] Yes, I'm calling from Saint Francis downtown.
[AGENT][NEUTRAL] OK, I'm gonna put you on a brief hold while I look up this claim for you and I'll be right back, sir.
[CUSTOMER][NEUTRAL] OK. You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Thank you for holding for me, Max. So looking on data service of [PII], I do not find a claim on file for the amount that you have given.
[CUSTOMER][NEUTRAL] OK. Uh, no problem. Could you please spell out your name for me?
[AGENT][NEUTRAL] Yes, sir. It's [PII]
[CUSTOMER][NEUTRAL] Initial to your last name, please?
[AGENT][NEUTRAL] A
[CUSTOMER][NEUTRAL] Thank you. And uh sorry, could you please confirm your mailing address so we can resubmit the claim?
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] Yes, sir. It's [PII], that's [PII]. That's in [PII].
[AGENT][NEUTRAL] And the zip code is [PII].
[CUSTOMER][NEUTRAL] OK, let me just give me a moment.
[CUSTOMER][NEUTRAL] OK. And after this [PII], is there anything else? It's dash uh after this?
[AGENT][NEUTRAL] 8
[AGENT][NEUTRAL] Uh, you can use 8950.
[CUSTOMER][POSITIVE] OK, thank you so much. And is there any payer ID or something?
[AGENT][NEUTRAL] Yes, the payer ID is 60801.
[CUSTOMER][POSITIVE] 60801. OK, thank you so much. And
[CUSTOMER][NEUTRAL] Thank you. And uh when I'm trying to search claim via portal, I'm trying to uh register via portal. So the uh the patient account number was uh showing invalid. So could you please help me how to check status via portal?
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, so.
[AGENT][NEUTRAL] What was showing in invalid, sir?
[CUSTOMER][NEUTRAL] Uh, first I'm, uh, mentioning the.
[CUSTOMER][NEUTRAL] Data, uh, the tax ID then they need medical, uh, they need patient account number. So I'll provided the, uh, member ID number here. So as I'm checking it showing error of no user found, uh, with this information that was entered. Please try again in the error process. Please contact customer service at and they provided the number option 4.
[AGENT][NEUTRAL] OK, and that is.
[CUSTOMER][NEUTRAL] So, could you please
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So you received a message stating to contact customer service because your tax ID was invalid, is that correct?
[CUSTOMER][NEGATIVE] No, the tax ID is correct. Uh, the, it shows, no, it doesn't show that the tax ID is correct. They said that no user was found with this information.
[AGENT][NEUTRAL] And you looked where to to find the information. Were you in the online service center?
[CUSTOMER][NEUTRAL] Uh, to American yes, on your portal, [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so in order to use the online service center a claim has to go through at least one time for the insured. Once that claim goes through and is paid then the um user, the information that we use is your account number for the insured so until a claim goes through it's gonna show that it's not there because the claim has to go through first.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Does that make sense? Because we use your because we use your patient account number.
[CUSTOMER][POSITIVE] Thank you, thank you for this. Yes.
[CUSTOMER][NEUTRAL] Yes, OK.
[CUSTOMER][NEUTRAL] OK, thank you. Thank you for this information. And is there any timely filing to commit the claim?
[AGENT][POSITIVE] You're very welcome.
[AGENT][NEGATIVE] No sir, there's no timely filing limit.
[CUSTOMER][POSITIVE] OK, thank you so much. What's the reference number for our call, please?
[AGENT][NEUTRAL] Yes, you can use my name and today's date.
[CUSTOMER][POSITIVE] OK, thank you so much, thank you for this information.
[AGENT][POSITIVE] You're very welcome. Is there anything else I can help you with before we go?
[CUSTOMER][NEUTRAL] No, thank you.
[AGENT][POSITIVE] Thank you and you have a wonderful day and thanks for calling APO.
[CUSTOMER][NEUTRAL] You too. Bye for now.