AccountId: 011433970860
ContactId: 6f62060e-948a-461c-b7a6-2ed4ef758fa7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 591859 ms
Total Talk Time (AGENT): 118871 ms
Total Talk Time (CUSTOMER): 289481 ms
Interruptions: 2
Overall Sentiment: AGENT=0.3, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/01/6f62060e-948a-461c-b7a6-2ed4ef758fa7_20250401T20:36_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh, could you please, uh, tell me your name again? I, I didn't hear you properly.
[AGENT][NEUTRAL] It's [PII], um, it's spelled [PII] and my last initial is [PII].
[CUSTOMER][NEUTRAL] Uh, OK, OK, AV AV, my name is [PII]. I'm calling for the provider Luisiana Cardiovascular and Thoracic Institute LLC. Please be informed that this call will be recorded and monitored for quality and training purposes. The reason for the call is claim status. May I know if I can help you with the patient's information or the provider's information?
[AGENT][NEUTRAL] Um, yes, sure, [PII]. First, I'll need a good callback number just in case we're disconnected.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] Uh, sure, uh, the callback number is [PII]. Direct line, no extension.
[AGENT][NEUTRAL] Thank you. And now I need the member's policy number.
[CUSTOMER][NEUTRAL] Uh, sure, the member's policy number is A as in Alpha 60003175.
[AGENT][NEUTRAL] OK, that's not one of our policy numbers. Do you have the member's social?
[CUSTOMER][NEUTRAL] Ah sure, give me a moment. I have to check that and I will provide you the same.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Uh, the member, uh, social security number is [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] But.
[CUSTOMER][NEUTRAL] This is.
[AGENT][NEUTRAL] OK, and please verify the member's name and date of birth.
[CUSTOMER][NEUTRAL] Uh, sure, the member's name is.
[CUSTOMER][NEUTRAL] [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] OK, and this is for a dental policy?
[CUSTOMER][NEUTRAL] Uh, no, this is medical policy.
[AGENT][NEUTRAL] OK. I'm only showing um one policy on file for her and it's for dental.
[AGENT][NEUTRAL] And the policy expired in [PII].
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Uh, for which date of service you're checking?
[AGENT][NEUTRAL] No, there are no claims on file.
[CUSTOMER][NEUTRAL] I'm looking for the claim status.
[AGENT][NEUTRAL] Right. I'm only showing one policy.
[CUSTOMER][NEUTRAL] But the uh.
[CUSTOMER][NEUTRAL] Uh, for the date, uh, [PII] and the total charges of $120.
[AGENT][NEUTRAL] OK. I'm not showing that claim on file for her. And I'm only showing a dental policy on file and the policy expired in [PII].
[CUSTOMER][NEUTRAL] And uh uh you're not, uh, what's the, do you know what was the patient active on data service?
[AGENT][NEUTRAL] No, the patient was not active on the date of service.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] And uh uh what is the uh for members effective date and the uh give me a moment.
[CUSTOMER][NEUTRAL] OK. Uh, may I know what is the policy, uh, member's policy effective date and the term that you have already given me as the term date which was expired on.
[CUSTOMER][NEUTRAL] You have [PII]. May I know the specific date for that?
[AGENT][NEUTRAL] Um, yes, sir, and just submit advise you that verification of coverage, it does not guarantee payment of claims. Um, the effective date on this policy was [PII].
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] And this policy expired on [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] And uh do you know when was when was the last COB updated?
[AGENT][NEUTRAL] No, it's not showing that in our system.
[CUSTOMER][NEUTRAL] Uh, OK. Uh, do you see any, uh, payer listed for this patient number?
[AGENT][NEUTRAL] No, sir.
[CUSTOMER][NEUTRAL] For, for this patient.
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Hey
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Give me a moment.
[CUSTOMER][NEUTRAL] May I know what is the preferred mode of submission?
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] It doesn't matter. You can either fax the claims in, you can mail them in, or you can use the payer ID which way do you prefer?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] We can email or we can use the we can send electronically using payer ID.
[CUSTOMER][NEUTRAL] Or fax. Could you help me with the uh claim submission time limit?
[AGENT][NEUTRAL] There's no time like filing limit?
[CUSTOMER][NEUTRAL] And what, what is the claim submission mailing address?
[AGENT][NEUTRAL] OK, it is American Public Life.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And that's in [PII].
[CUSTOMER][NEGATIVE] Shut up. Hey, it's inside.
[AGENT][NEUTRAL] And the zip code is [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, give me a moment just to reconfirming the information. The claim submission mailing address is American Public Life and the, um, it is, uh, to the PO box.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] No.
[AGENT][POSITIVE] Mhm, that's correct.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And uh zip code is [PII].
[AGENT][NEUTRAL] Yes sir.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] And uh, may, may, may I know the, give me a moment. May I know the timely filing limit to submit the corrected claim?
[AGENT][POSITIVE] There's no timeless silent limit.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] And uh the address where the, is the the same for the corrected claim?
[AGENT][NEUTRAL] Yes, it is.
[CUSTOMER][NEUTRAL] OK, and uh uh what will be the call reference number for this?
[AGENT][NEUTRAL] The call reference number is my name and today's date. My name is [PII]. Um it's spelled [PII] Last initial is [PII], and today's date. Is there anything else that I can assist you with?
[CUSTOMER][POSITIVE] Uh, no, thank you. I have received all the information for this member. Thank you for providing the information for this member. Thank you for your assistance and have a great day ahead and bye for now. Take care.
[AGENT][NEUTRAL] You do the same, [PII]. Thank you for calling APL. Mm bye.
[CUSTOMER][NEUTRAL] Yeah that's the same that give you.