AccountId: 011433970860
ContactId: 763b2331-40a8-4dd2-9a8e-0ecf4fa8fdcf
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 700559 ms
Total Talk Time (AGENT): 213690 ms
Total Talk Time (CUSTOMER): 155922 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/05/763b2331-40a8-4dd2-9a8e-0ecf4fa8fdcf_20250505T14:47_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII]. I'm calling from provider office to verify claim status.
[AGENT][NEUTRAL] OK, I could check on a claim for you. Uh, sir, can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure, the callback number is [PII].
[AGENT][NEUTRAL] Thank you and then do you have that policy number?
[CUSTOMER][NEUTRAL] Uh yes. The policy number is 02304093.
[AGENT][NEUTRAL] OK and then what was the name and date of birth for the member please?
[CUSTOMER][NEUTRAL] Uh, member name is [PII] and the date of birth is [PII].
[AGENT][POSITIVE] Perfect, thank you for verifying that and what was the date of service for this claim?
[CUSTOMER][NEUTRAL] Later services [PII].
[AGENT][NEUTRAL] [PII] and then uh what was that uh billed amount please?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] And total bill amount is $4,969.25.
[AGENT][POSITIVE] Got it thank you one moment please.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] Alright, I need the tax ID for this provider.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Tax ID is [PII].
[AGENT][NEUTRAL] OK thank you one moment.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK, I am not showing that we have received that claim, [PII].
[CUSTOMER][NEUTRAL] And can you provide me the member effective date?
[AGENT][NEUTRAL] Yes, this policy's effective date was [PII], and it is currently active.
[CUSTOMER][NEUTRAL] And thank you. Could you also provide me the payer ID and claim mailing address?
[AGENT][NEUTRAL] Of course, I've also got a fax number as well. So our mailing address is [PII].
[AGENT][NEUTRAL] 950.
[AGENT][NEUTRAL] And that is in [PII] City, [PII].
[AGENT][NEUTRAL] Zip code is [PII].
[CUSTOMER][NEUTRAL] Thank you. Can you provide me the time refunding limit to submit the claim?
[AGENT][NEGATIVE] There is no timely filing limit.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Did you want that fax number or just the payer ID?
[CUSTOMER][NEUTRAL] I have 3 more claims.
[CUSTOMER][NEUTRAL] Uh, can you provide me both?
[AGENT][NEUTRAL] Sure, that fax number is 877.
[AGENT][NEUTRAL] 365.
[AGENT][NEUTRAL] 942 3.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then that payer ID, yes, that is uh 60801.
[CUSTOMER][NEUTRAL] And payer ID?
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] I have 3 more claims. Can you assist me with that?
[AGENT][NEUTRAL] Are these for the same member or are those claims for different members?
[CUSTOMER][NEUTRAL] Of a different member.
[AGENT][NEUTRAL] OK, yes, uh, one moment please I'll let you know when I'm ready for that.
[CUSTOMER][NEUTRAL] OK, sure.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, um, you could go ahead and give me that next policy number when you're ready, [PII].
[CUSTOMER][NEUTRAL] Oh yes. The member ID is 2473446.
[AGENT][NEUTRAL] OK and then what was the name and date of birth for this number?
[CUSTOMER][NEUTRAL] Uh my name is [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you for verifying that and then uh what was the date of service for this claim?
[CUSTOMER][NEUTRAL] Date of service is [PII].
[AGENT][NEUTRAL] OK, and then that bill amount please.
[CUSTOMER][NEUTRAL] The amount is $232 even.
[AGENT][NEUTRAL] OK and was this for the same, uh, from the same provider [PII]?
[AGENT][NEUTRAL] As the other one?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK thank you one moment.
[CUSTOMER][NEUTRAL] Yes, yes.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK, so we have not received this claim either.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And just can you provide me the member effective date for this member?
[AGENT][NEUTRAL] Of course that effective date was [PII] and it is currently active.
[CUSTOMER][POSITIVE] OK, thank you. And I have a next member?
[AGENT][NEUTRAL] OK, yes, one moment please. I'll let you know when I'm ready.
[CUSTOMER][NEUTRAL] Oh, sure.
[AGENT][NEUTRAL] OK, you can go ahead with that next policy number, [PII].
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Next policy number is?
[CUSTOMER][NEUTRAL] 02568293
[AGENT][NEUTRAL] OK, and then uh what was the name and date of birth for this number, please?
[CUSTOMER][NEUTRAL] Our member name is [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] Thank you for that and then what was this uh date of service?
[CUSTOMER][NEUTRAL] Data services [PII].
[AGENT][NEUTRAL] OK, and then that bill amount please.
[CUSTOMER][NEUTRAL] And the amount is $232 even.
[AGENT][NEUTRAL] Got it. One moment please.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK, so we did receive this claim Miss [PII], uh, we were unable to pay a benefit as this is not a covered loss under this plan.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Not covered loss and.
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] I can send you this uh EOB if you'd like uh from the patient's plan.
[CUSTOMER][NEUTRAL] And a patient or providers plan?
[CUSTOMER][NEUTRAL] OK. For this, we need to be patient for this?
[AGENT][NEUTRAL] We don't say what is patient responsibility that would be up to the provider.
[CUSTOMER][NEUTRAL] Thank you. And can you provide me the claim number?
[AGENT][NEUTRAL] Yes, that is 3551314.
[CUSTOMER][NEUTRAL] Oh,
[CUSTOMER][POSITIVE] And have next member whenever you're ready.
[AGENT][NEUTRAL] Oh, yes, um, one moment please.
[CUSTOMER][NEUTRAL] Sure
[AGENT][POSITIVE] OK, I appreciate your patience, [PII]. You can go ahead with that next policy number.
[AGENT][NEUTRAL] Hello [PII], are you still there?
[AGENT][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Yes, so sorry. Can you hear me?
[AGENT][NEUTRAL] Oh, that's OK, yes.
[CUSTOMER][NEUTRAL] Uh, can you provide me the member ID?
[AGENT][NEUTRAL] Um,
[AGENT][POSITIVE] Yes, if you would give me that next policy number, I'm ready.
[CUSTOMER][NEUTRAL] Sure, it's 2456682.
[AGENT][NEUTRAL] OK, and then the name and date of birth for this number please?
[CUSTOMER][NEUTRAL] Our member name is [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you for that and then uh what was the date of service?
[CUSTOMER][NEUTRAL] Date of service is [PII].
[AGENT][NEUTRAL] OK, and then I bill them out please.
[CUSTOMER][NEUTRAL] Total bill amount is $986 even.
[AGENT][NEUTRAL] OK thank you one moment.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK, just to clarify, I'm so sorry you did say that was [PII]?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh yes. No sorry, [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Oh, [PII]. OK, one moment.
[CUSTOMER][NEUTRAL] Yes. Sure.
[AGENT][NEUTRAL] OK, so we have not received this claim, [PII].
[CUSTOMER][NEUTRAL] Yeah. OK. And just can you provide me the member effective date?
[AGENT][NEUTRAL] Sure, that effective date was [PII] and it is currently active.
[CUSTOMER][NEUTRAL] Can you provide me the call reference number?
[AGENT][NEUTRAL] That would just be my first name, last initial, and today's date. Uh, so my name is spelled [PII], last [PII]
[AGENT][NEUTRAL] Was there anything else I could help you with sir?
[CUSTOMER][POSITIVE] Uh, no. Thank you so much for assisting me. Have a nice day. Stay safe and bye-bye.
[AGENT][POSITIVE] Of course, thanks for calling APL you too bye bye.