AccountId: 011433970860
ContactId: 79ecb5c7-7a96-42a2-8a64-21b9472ad348
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 404040 ms
Total Talk Time (AGENT): 136010 ms
Total Talk Time (CUSTOMER): 164074 ms
Interruptions: 1
Overall Sentiment: AGENT=0, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/24/79ecb5c7-7a96-42a2-8a64-21b9472ad348_20250624T16:50_UTC.wav
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[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Hello.
[AGENT][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] No
[AGENT][NEUTRAL] Hello, are you able to hear me, caller? Thanks for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Yeah, [PII]. I'm [PII]. I'm calling you from the provider's office.
[CUSTOMER][NEUTRAL] No
[AGENT][NEUTRAL] [PII], can I have a callback number for you and the reason for your call?
[CUSTOMER][NEUTRAL] Yeah, sure. My callback number [PII]. And I'm calling to verify the um
[CUSTOMER][NEUTRAL] Claims information.
[AGENT][NEUTRAL] Could you repeat that callback number?
[CUSTOMER][NEUTRAL] And callback number is [PII].
[AGENT][NEUTRAL] [PII], what is the policy number of the member that you're calling to check the status of a claim for?
[CUSTOMER][NEUTRAL] Yeah, the member's policy number is 02549447.
[AGENT][NEUTRAL] Can you verify the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Patient name is [PII]. Date of birth is [PII].
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] And what is the date of service that you're calling to check the status of a claim for?
[CUSTOMER][NEUTRAL] Hi
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And what is your procedure code for that claim?
[CUSTOMER][NEUTRAL] 73218, modify LT.
[AGENT][NEUTRAL] And what is the bill amount?
[CUSTOMER][NEUTRAL] $1,871 even.
[AGENT][NEGATIVE] Unfortunately, I'm not showing the claim on file for [PII].
[CUSTOMER][NEUTRAL] OK. Um
[CUSTOMER][NEUTRAL] Could you verify the mailing address and pay ID?
[AGENT][NEUTRAL] Payer ID is 60801.
[CUSTOMER][NEUTRAL] The.
[AGENT][NEUTRAL] The mailing address will be addressed to APL claims department.
[CUSTOMER][NEUTRAL] OK, [PII].
[AGENT][NEUTRAL] [PII]. That's [PII].
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK. May I know the patient plan effective on term date?
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] This member's policy became effective [PII].
[AGENT][NEUTRAL] And it's currently active.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] [PII] to current.
[AGENT][POSITIVE] Yes, that is correct, [PII]. Is there anything else that I can assist you with today?
[CUSTOMER][NEUTRAL] OK. Um,
[CUSTOMER][NEUTRAL] Yeah. May I know the time limit for claim submission?
[AGENT][NEGATIVE] There is no timely filing.
[CUSTOMER][NEUTRAL] No timely filing. So, OK, uh, I want to verify one more information.
[CUSTOMER][NEUTRAL] Oh,
[CUSTOMER][NEUTRAL] We submit the claims uh to the address, but uh our cleaning was reject the claim. The reason for the billing address was incorrect. May I know the, could you verify the, what do you have, uh, our address?
[AGENT][NEUTRAL] Could you repeat your question cause I didn't I didn't understand you.
[CUSTOMER][NEUTRAL] Mm, what do you have our address, uh, could you verify that, uh, our address for you on file?
[AGENT][NEUTRAL] Your address?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] How about your, we don't need your billing address for you to submit a claim to us.
[CUSTOMER][NEUTRAL] No, no, no. My question is, I, I understand what you said, but I uh I need to verify what do you have?
[AGENT][NEUTRAL] What do you mean? What do I have?
[CUSTOMER][NEUTRAL] For our providers, sir.
[CUSTOMER][NEUTRAL] Mm, [PII], um, uh, our provider is SMI Imaging LLC.
[AGENT][NEUTRAL] I do apologize, but I'm not understanding you.
[CUSTOMER][NEUTRAL] Mm, OK.
[CUSTOMER][NEUTRAL] One moment.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] Is there anything else that I can assist you with, [PII]?
[CUSTOMER][NEUTRAL] OK. Uh, yeah.
[CUSTOMER][NEUTRAL] Yeah, yeah, uh, this, uh, the claim was for the address was invalid. Could you verify the address?
[AGENT][NEUTRAL] So I just gave you the address. Would you like for me to repeat it again? The [PII].
[CUSTOMER][NEUTRAL] No, no. Uh, uh, say, one moment.
[CUSTOMER][NEUTRAL] I'm not asking for that question, sir. My question is different. The address is different.
[AGENT][NEUTRAL] That's not our mailing address. I just provided you with the correct mailing address for claim.
[CUSTOMER][NEUTRAL] Not, yeah, yeah, yeah, I, I understand. I'm not asking for your mailing address. I ask you for verify our mailing address.
[AGENT][NEUTRAL] The who mailing address?
[CUSTOMER][NEUTRAL] Our providers
[AGENT][NEUTRAL] I wouldn't know who your provider is because we don't have a claim on file for the mem when you call to check the status of a claim, there is no claim on file under the profile for [PII] for you. So I'm not sure who's your provider. What is your provider's address? You have to reach out to whomever it is that you're employed with to verify the billing address or whatever type of address it is concerning your employer, because I don't, I wouldn't have that information, [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, what is the card reference number?
[AGENT][NEUTRAL] We don't provide those. You can use my name in today's date as a reference. It's [PII] and today's date as a reference. Is there anything else that I can assist you with today, [PII]?
[CUSTOMER][POSITIVE] Not for now. Thank you for asking me. Thank you for your assistance, Sayah.
[AGENT][POSITIVE] Thanks for calling APL. Have a good day. Bye.