AccountId: 011433970860
ContactId: 7abbec2f-bd12-4ace-9038-5469fdb8f0bd
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 657669 ms
Total Talk Time (AGENT): 162805 ms
Total Talk Time (CUSTOMER): 242638 ms
Interruptions: 2
Overall Sentiment: AGENT=0.1, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/28/7abbec2f-bd12-4ace-9038-5469fdb8f0bd_20250528T19:08_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hey, my name is [PII]. I'm calling from provider's office to check the claim status. May I know your name one more time?
[AGENT][NEUTRAL] Sure, it's [PII], last initial [PII] and [PII], what is the policy number, please?
[CUSTOMER][NEGATIVE] OK, uh, I just want to know one thing. I have connected with two representatives. They directly hang up the call. Exactly, I, I, uh, I'm not getting what was happened with me.
[AGENT][NEUTRAL] OK. Well, I'm not sure what's going on, but what's the policy number you're inquiring about?
[CUSTOMER][NEUTRAL] It's 018260.
[CUSTOMER][NEUTRAL] 85 M as in Mary, L as in Lima, 8.
[AGENT][NEUTRAL] OK, thank you. And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] Yeah, the callback number [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and verify the patient's name, date of birth.
[CUSTOMER][NEUTRAL] Patient first name [PII] and last name [PII] and the date of birth [PII].
[AGENT][NEUTRAL] OK, and what was the date of service and amount of the charge?
[CUSTOMER][NEUTRAL] The date of service [PII] and the total charge on $150.
[AGENT][NEUTRAL] And what was the balance after primary?
[CUSTOMER][NEUTRAL] The balance after the primary is showing 34 dollars.5 cents.
[AGENT][NEUTRAL] OK, one moment please.
[AGENT][NEUTRAL] And you said data service is [PII] at [PII]?
[CUSTOMER][POSITIVE] Perfect.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][POSITIVE] Perfect. The date of service is [PII].
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Did you find the patient in your system?
[AGENT][NEUTRAL] I am looking for the claim. Hold one moment, please. Thank you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And I don't show the claim has been received. Can you verify the mailing address the claim was submitted to?
[CUSTOMER][NEUTRAL] The name was submitted on the through payer ID. It's showing 60801.
[AGENT][NEUTRAL] OK, that is correct payer ID. If you like, I can give you a fax number if you would like to fax the claim, but we have not received this claim.
[CUSTOMER][NEUTRAL] Can you tell me the mailing address?
[AGENT][NEUTRAL] Sure, [PII].
[AGENT][NEUTRAL] Oklahoma City, Oklahoma.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, just verify the uh address [PII].
[CUSTOMER][NEUTRAL] [PII]. And the ZIP code [PII], right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Just 2.
[CUSTOMER][NEUTRAL] And can you please provide me the fax number?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And as, as we get from the payer ID it's correct, right? 60801.
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] Can you tell me the time limit?
[AGENT][NEUTRAL] There isn't one.
[CUSTOMER][NEUTRAL] What one?
[AGENT][NEGATIVE] We do not have a timely filing.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, is there anything else I can assist you with today?
[CUSTOMER][NEUTRAL] May I know the patient uh policy effective date?
[AGENT][NEUTRAL] Sure, it's [PII]. Policy is active.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And I have one more claim. Can we move for the next patient?
[AGENT][NEUTRAL] It's for a different patient.
[CUSTOMER][NEUTRAL] For a different patient.
[AGENT][NEUTRAL] OK, one moment, please.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] May I know the reference number for this one?
[AGENT][NEUTRAL] We don't give reference numbers. If you like, you may use my name is [PII] State.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So once you're ready, then let me know for the next question for the next question.
[AGENT][NEUTRAL] I will let you know when I'm ready. Hold on one moment, please. Thank you.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK. What is next policy number?
[CUSTOMER][NEUTRAL] Next patient policy number.
[CUSTOMER][NEUTRAL] It's 1973189.
[AGENT][NEUTRAL] OK, patient's name, date of birth?
[CUSTOMER][NEUTRAL] Patient first name [PII], last name [PII], and the date of birth, [PII].
[AGENT][NEUTRAL] OK, date of service model of the charge.
[CUSTOMER][NEUTRAL] And the date is [PII] and the total charge on $1950 even.
[AGENT][NEUTRAL] Balance after primary.
[CUSTOMER][NEUTRAL] The balance after Prime reaching $250.
[AGENT][NEUTRAL] And the name of the provider's office?
[CUSTOMER][NEUTRAL] Which is copay.
[CUSTOMER][NEUTRAL] The provider's office name like Imagine LLC.
[AGENT][NEUTRAL] And I don't show we received that claim. Can you verify the address it was submitted to?
[CUSTOMER][NEUTRAL] It was submitted on the same Per ID 60801.
[AGENT][NEUTRAL] OK, that is correct. So you can either mail it or fax it to us.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] No issue. Can you help me the patient, effective date? Is this patient active or not?
[AGENT][NEUTRAL] Effective date [PII], policy is active.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And rest the same, right?
[CUSTOMER][NEUTRAL] Mailing address and fax number.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] So I'm done for this patient. Can we move for the next patient?
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, what is the next policy number?
[CUSTOMER][NEUTRAL] Next patient's policy number is 01826085 M as in Mary.
[CUSTOMER][NEUTRAL] L as in Lima.
[CUSTOMER][NEUTRAL] Number 8.
[AGENT][NEUTRAL] Patient's name, date of birth?
[CUSTOMER][NEUTRAL] first name [PII], last name [PII], and the date of birth [PII].
[AGENT][NEUTRAL] OK, what other claim are you inquiring for this patient?
[AGENT][NEUTRAL] What's the data service amount of the charge?
[CUSTOMER][NEUTRAL] Date of service [PII] and the total charge amount $225 even.
[AGENT][NEUTRAL] Oh, we have not received that claim.
[CUSTOMER][POSITIVE] No issue.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK. Can we move for the last question? This, this person is last question.
[AGENT][NEUTRAL] What is the policy number?
[CUSTOMER][NEUTRAL] Sure, just a moment.
[CUSTOMER][NEUTRAL] Patient policy number.
[CUSTOMER][NEUTRAL] 024
[CUSTOMER][NEUTRAL] 398
[CUSTOMER][NEUTRAL] 94 M as in Mary, L as in Lima, number 8.
[AGENT][NEUTRAL] Patient's name, date of birth?
[CUSTOMER][NEUTRAL] The patient's first name [PII] and last name [PII], and the date of birth [PII].
[AGENT][NEUTRAL] Data service amount of the charge.
[CUSTOMER][NEUTRAL] The date of service is [PII].
[CUSTOMER][NEUTRAL] And the total charge amount is $615 even.
[AGENT][NEUTRAL] Balance after primary.
[CUSTOMER][NEUTRAL] The balance after primary is showing 110.21.
[CUSTOMER][NEUTRAL] Dollar.
[AGENT][NEUTRAL] Do that one more time.
[CUSTOMER][NEUTRAL] I'll repeat, it's 110.21.
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And we have not received that c[PII]. Can you verify that mailing address the claim was submitted to?
[CUSTOMER][NEUTRAL] The all claim was submitted through PO ID which is 60801.
[AGENT][NEUTRAL] OK. Like I said, we have not received the claim.
[CUSTOMER][POSITIVE] No issue. May I know the effective date for this one?
[AGENT][NEUTRAL] Sure, [PII], policy is active.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you so much. You've been a great help, [PII]. I'm done from my by, take care.
[AGENT][NEUTRAL] Uh-huh, thank you for calling APL bye.