AccountId: 011433970860
ContactId: 6f146de6-b2fd-4140-8835-3323dcc884a3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 325670 ms
Total Talk Time (AGENT): 125053 ms
Total Talk Time (CUSTOMER): 85143 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/31/6f146de6-b2fd-4140-8835-3323dcc884a3_20250131T21:38_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from Prada's office to check on claim status, please.
[AGENT][NEUTRAL] Yeah, sure. I can assist you with claim status, Ms. [PII]. May I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, and you're calling from which uh facility or location?
[CUSTOMER][NEUTRAL] It is Center for Digestive Health for Central Florida.
[AGENT][NEUTRAL] OK, and may I have the patient's policy number, Miss Honey?
[CUSTOMER][NEUTRAL] policy
[CUSTOMER][NEUTRAL] It is 01618297.
[AGENT][NEUTRAL] OK thank you one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] It is [PII], and the date of birth is [PII].
[AGENT][POSITIVE] Perfect, thank you. And may I have the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] Date of service is.
[CUSTOMER][NEUTRAL] [PII]. The amount is $1200 even.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And for the future, you can check claim status online through our website at [PII]. That's just optional.
[CUSTOMER][NEUTRAL] At
[AGENT][NEUTRAL] Yeah, let's see.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And you said the total charge was 1200?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Mm OK.
[AGENT][NEUTRAL] What is the procedure code?
[CUSTOMER][NEUTRAL] 4538043239
[AGENT][NEUTRAL] OK, we have not received a claim from the provider for that data service in that amount.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. The no claim on file.
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] May I know the patient policy effective date?
[AGENT][NEUTRAL] Sure. Let's see.
[AGENT][NEUTRAL] Effective date on this policy is [PII] and it is active at the moment. This is one of our secondary supplemental plan to the major medical.
[CUSTOMER][NEUTRAL] OK. Patient plan effective from [PII], right?
[AGENT][POSITIVE] Yes, correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And may I know the timely filing limit to send the claim?
[AGENT][NEUTRAL] We don't have timely funding limits.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK. May I know your mailing address?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK just a moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And uh
[CUSTOMER][NEUTRAL] Do you have a payer ID?
[AGENT][NEUTRAL] OK, uh, we do have a payer ID, but this is one of our secondary supplemental plan to the major medical. So the claim needs to be either fax or mailed because we need the explanation of benefits from the primary insurance attached to it.
[CUSTOMER][NEUTRAL] for now.
[CUSTOMER][NEUTRAL] That's fine.
[CUSTOMER][NEUTRAL] Yes, but uh to verify, I need a payer ID.
[AGENT][NEUTRAL] OK, that's 60801.
[CUSTOMER][NEUTRAL] 60801.
[AGENT][POSITIVE] Mhm, correct.
[CUSTOMER][NEUTRAL] Uh, may I know fax number?
[AGENT][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] It is [PII], right?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] Can you spell out your name for me, please?
[AGENT][NEUTRAL] My name is [PII]. That's [PII]. Last initial is [PII].
[CUSTOMER][NEUTRAL] I'll let you know.
[CUSTOMER][NEUTRAL] Call reference number for this number?
[AGENT][NEUTRAL] We don't have reference numbers, you can use my name in today's date if you will.
[CUSTOMER][POSITIVE] OK. So thank you. Thank you for your assistance. Have a great day.
[AGENT][POSITIVE] You're welcome. You as well, and thank you for calling APL.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Bye.
[AGENT][NEUTRAL] Bye bye.