AccountId: 011433970860
ContactId: 7bff575b-931c-43f7-bbbe-05eecdaaba53
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 407739 ms
Total Talk Time (AGENT): 179875 ms
Total Talk Time (CUSTOMER): 175235 ms
Interruptions: 13
Overall Sentiment: AGENT=1, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/01/7bff575b-931c-43f7-bbbe-05eecdaaba53_20250501T13:19_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][POSITIVE] Good morning, thank you for calling ATL.
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from provider's office to check on our claim status. How are you doing today?
[AGENT][POSITIVE] I'm good, [PII]. And you said, how are you today?
[CUSTOMER][POSITIVE] OK thanks.
[CUSTOMER][POSITIVE] Yeah, I'm good thanks for asking [PII].
[AGENT][POSITIVE] Good and my name is [PII]
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And [PII], you said that you have one claim to check status on, is that correct?
[CUSTOMER][NEUTRAL] you said that you have.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Yes, ma'am. I can help you with that. And what is your callback number, please?
[CUSTOMER][NEUTRAL] I help me with that.
[CUSTOMER][NEUTRAL] [PII] Direct line no extension.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And [PII], what is the patient's policy number?
[CUSTOMER][NEUTRAL] It's 021-9946.
[AGENT][NEUTRAL] Thank you one moment please while I get the member's information pulled up.
[AGENT][NEUTRAL] OK, what was the policy number one more time because I think we're missing a number, [PII].
[CUSTOMER][NEUTRAL] Because I think we're missing a number, [PII].
[CUSTOMER][NEUTRAL] 021-9946.
[AGENT][NEUTRAL] OK, yes ma'am, that's not a valid policy number.
[CUSTOMER][NEUTRAL] I guess that's my policy number.
[AGENT][NEUTRAL] Do you have a copy of the ID card?
[CUSTOMER][NEUTRAL] you have a copy of the ID card.
[CUSTOMER][NEUTRAL] Just a moment, let me check that.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 0219946.
[CUSTOMER][NEUTRAL] Uh, unfortunately, I don't have an ID card. Are you able to search with the name of the patient, name and the date of birth?
[AGENT][NEUTRAL] I can't search with date of birth. Do you have the full social security number?
[CUSTOMER][NEUTRAL] That search with date of birth. Do you have the full question.
[CUSTOMER][NEUTRAL] Mm, yes.
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK thank you one moment.
[AGENT][NEUTRAL] OK, and OK, so any information that I excuse me, any information that I provide for you, [PII] will be a verification of benefits and not a guarantee of payment. What is your patient's name please and their date of birth?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] that I provide for you sir will be.
[CUSTOMER][NEUTRAL] Patients date of birth is [PII] and the patient name is
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII], the last name spelled [PII]
[AGENT][NEUTRAL] OK, thank you and what is going to be the data service and total bill amount?
[CUSTOMER][NEUTRAL] The date of service is [PII] and the bill amount is $9,091.07.
[AGENT][NEUTRAL] OK, thank you. So the correct policy number before I can look for the data service that you should have for this number is 02.
[AGENT][NEUTRAL] 31.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] 9946.
[CUSTOMER][NEUTRAL] 9946.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] You're welcome. And give me just a moment to get that information pulled up.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] OK, and [PII], we did not have a claim on file for her for that data service.
[CUSTOMER][NEUTRAL] for the service.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK. So, could you please tell me your payer ID and the mailing address?
[AGENT][NEUTRAL] The mailing OK, the payer ID first off is 60801.
[CUSTOMER][NEUTRAL] The mailing OK the payer.
[AGENT][NEUTRAL] And the payer of the mailing address rather is PO Box.
[CUSTOMER][NEUTRAL] of the banks.
[CUSTOMER][NEUTRAL] Hm?
[AGENT][NEUTRAL] Excuse me.
[AGENT][NEUTRAL] 248,950.
[CUSTOMER][NEUTRAL] 248.
[CUSTOMER][NEUTRAL] 950.
[AGENT][NEUTRAL] That's [PII].
[CUSTOMER][NEUTRAL] That's [PII].
[AGENT][NEUTRAL] And the zip code is going to be [PII].
[CUSTOMER][NEUTRAL] So the zip code is going to be [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] And what is the timely filing limit to submit the claim?
[AGENT][NEGATIVE] There is no timely filing limit?
[CUSTOMER][NEUTRAL] There is no time
[CUSTOMER][NEUTRAL] W
[AGENT][NEUTRAL] And we will have to have a copy of the primary insurance company's explanation of benefits along with the claim for review.
[CUSTOMER][NEUTRAL] OK we will have to have a copy of the insurance company explanation of benefits along with the receipt.
[AGENT][NEUTRAL] And then once we have processed our claim here at APL, sir, we do have a portal in which you should be able to check claim status.
[CUSTOMER][NEUTRAL] Mm, OK.
[CUSTOMER][NEUTRAL] we do have a portal and what you should be able.
[AGENT][NEUTRAL] And the portal website is located at [PII].
[CUSTOMER][NEUTRAL] OK, thank you. And I need to know the patient's plan type effective date and termination date.
[AGENT][NEUTRAL] This is a supple was a supplemental policy to her primary insurance called Medlink M E D L I N K.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] The insurance company naturally.
[AGENT][NEUTRAL] The effective date was [PII] and a term date of [PII].
[CUSTOMER][NEUTRAL] on
[CUSTOMER][POSITIVE] OK, thank you. And um
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] For billing purpose, is there any specific group number or group name?
[AGENT][NEUTRAL] Group number is 24149.
[CUSTOMER][POSITIVE] Good number.
[CUSTOMER][NEUTRAL] 149
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Thank you. Um, that's it for today. Could you please provide me the call reference number?
[AGENT][NEUTRAL] Yes ma'am, you would use my name along with today's date.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] OK, [PII]. Thank you. Thank you for your time and assistance. Have a great day.
[AGENT][POSITIVE] You're welcome. Yes, ma'am. Well, if that's all I can help you with, thank you for calling APL today, sir, and I hope you have a nice day [PII]o.
[AGENT][NEUTRAL] Uh-huh