AccountId: 011433970860
ContactId: 7502565c-3a1c-4df2-b65b-33514087720c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 572760 ms
Total Talk Time (AGENT): 136562 ms
Total Talk Time (CUSTOMER): 174738 ms
Interruptions: 1
Overall Sentiment: AGENT=1, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/17/7502565c-3a1c-4df2-b65b-33514087720c_20250317T13:53_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, what's your name?
[AGENT][NEUTRAL] My name is [PII], that's [PII]
[CUSTOMER][NEUTRAL] OK. Hi, my name is [PII] and I'm calling for the provider [PII]. Please be informed that this call is being recorded and monitored for quality and training purposes. I'm calling to check on a claim status.
[AGENT][NEUTRAL] OK, sure, I can assist your claim status at that right.
[CUSTOMER][NEUTRAL] May I know?
[AGENT][NEUTRAL] Go ahead.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, so may I know if I can help you with the patient's information or the provider information?
[AGENT][NEUTRAL] Sure, I can assist you with claim status, Miss [PII]. Um, may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Uh yes, sure. The callback number will be [PII].
[CUSTOMER][NEUTRAL] [PII]. No extension direct line.
[AGENT][NEUTRAL] OK, and may I have the patient's policy number, Miss [PII]?
[CUSTOMER][NEUTRAL] Patience
[CUSTOMER][NEUTRAL] Policy number?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So you mean to say member ID?
[AGENT][NEUTRAL] Mm, it depends if it's starting with the D, that's not gonna be our number, but it's gonna be starting with the 0 followed by 7 digits. That's the policy number.
[CUSTOMER][NEUTRAL] Yeah, it's a member ID so it's 7 digits.
[AGENT][NEUTRAL] OK, go ahead with the number.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Sure. The member ID is 154.
[CUSTOMER][NEUTRAL] 8949.
[AGENT][POSITIVE] Thank you, one moment.
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Oh sure. The name of the patient is [PII]. It's [PII] and the last name will be [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] OK. Thank you. And what is the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] Sure. The date of service is [PII] and the bill amount will be 300 and $300 even.
[AGENT][NEUTRAL] $300 even.
[CUSTOMER][POSITIVE] Yeah, that's correct.
[AGENT][NEUTRAL] And that was [PII].
[CUSTOMER][POSITIVE] That's right.
[AGENT][NEUTRAL] OK, bear with me.
[AGENT][NEUTRAL] What is the procedure code?
[CUSTOMER][NEUTRAL] Let me check. One moment, please.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] You
[CUSTOMER][POSITIVE] Thank you for being online. I appreciate your patience. So it's S as in Sierra 9083.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] I don't see that claim on file.
[CUSTOMER][NEUTRAL] OK, no issues. So you want to say the claim is not on file. One moment.
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][POSITIVE] Thank you so much for being online.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, so is the patient active on date of service?
[AGENT][NEUTRAL] No. Um, let me give you the termination date, um.
[AGENT][NEUTRAL] Oh yes, she was. OK, so the um effective date on this policy is [PII] and it terminated on [PII].
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] The termination date will be [PII], right?
[AGENT][NEUTRAL] [PII]. Correct, yes. Mhm.
[CUSTOMER][NEUTRAL] OK, so the patient is active on date of service.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, OK.
[CUSTOMER][NEUTRAL] So, are you primary or secondary insurance?
[AGENT][NEUTRAL] This is the secondary.
[CUSTOMER][POSITIVE] OK. Thank you so much.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] So, may I know the time to filing for information?
[AGENT][NEUTRAL] We don't have time to find limits.
[CUSTOMER][POSITIVE] OK. Thank you so much.
[AGENT][POSITIVE] You're welcome. Is there anything else I can help you with today?
[CUSTOMER][NEUTRAL] So,
[CUSTOMER][NEUTRAL] Yes. Uh, so may I know the claim submission, mailing address and the pay ID?
[AGENT][NEUTRAL] OK, um, we don't have timely filing limits.
[AGENT][NEUTRAL] The address is [PII].
[AGENT][NEUTRAL] [PII]. The zip code is [PII].
[AGENT][NEUTRAL] Um, this claim needs to be either faxed or mail.
[AGENT][NEUTRAL] OK, and the pay ID?
[CUSTOMER][NEUTRAL] OK, so preferred mode of submission.
[AGENT][NEUTRAL] Mhm, go ahead.
[CUSTOMER][NEUTRAL] Yeah, yeah. The preferred mode will be the mail or.
[AGENT][NEUTRAL] Fax or mail.
[CUSTOMER][NEUTRAL] Mail or fax, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK. So,
[CUSTOMER][NEUTRAL] What is the payer ID?
[AGENT][NEUTRAL] The payer ID for your records is 60801.
[CUSTOMER][NEUTRAL] 60801.
[AGENT][POSITIVE] Mhm, correct.
[CUSTOMER][NEUTRAL] OK. So,
[CUSTOMER][NEUTRAL] One moment. Let me check the details.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Thank you so much for being on line.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, so may I have the reference number?
[AGENT][NEUTRAL] We don't have reference numbers, you can use my name in today's date.
[CUSTOMER][NEUTRAL] OK. So your name is [PII], right?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII], right?
[AGENT][POSITIVE] Yes, correct.
[CUSTOMER][NEUTRAL] OK. And this date.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. So that's it from my side?
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you so much for your assistance.
[AGENT][POSITIVE] You're welcome and thank you for calling APO. Have a good day. Yeah.
[CUSTOMER][POSITIVE] Have a good day too.
[AGENT][POSITIVE] Thank you. Bye bye.