AccountId: 011433970860
ContactId: 7d6cf705-3acc-4d33-ad57-7daa6ae1a44b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 298049 ms
Total Talk Time (AGENT): 88081 ms
Total Talk Time (CUSTOMER): 116118 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/12/7d6cf705-3acc-4d33-ad57-7daa6ae1a44b_20250512T18:35_UTC.wav
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[CUSTOMER][NEUTRAL] That's it.
[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII], this is [PII] calling from provider's office, checking on claim status.
[AGENT][NEUTRAL] OK, well, I'll be more than happy to help you with the claim status, [PII]. And how many claims do you have in total today?
[CUSTOMER][NEUTRAL] On one claim.
[AGENT][NEUTRAL] Alright, and may I have a good contact number in case we're disconnected and the policy number?
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] [PII]. And the policy number 01.
[CUSTOMER][NEUTRAL] 88
[CUSTOMER][NEUTRAL] 3790, M as in Mike, L as in Lima, number 8.
[CUSTOMER][NEUTRAL] And I.
[AGENT][NEUTRAL] Thank you for that. And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Uh, [PII]. And uh date of birth, [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And may I have the date of service and the total bills for the claim?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, and the date of service [PII].
[CUSTOMER][NEUTRAL] And the bill amount for this claim is $3,4 even 3004 even.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][POSITIVE] Yeah, you're welcome.
[CUSTOMER][NEUTRAL] So.
[AGENT][NEUTRAL] And can you verify the name of the provider's office on the claim?
[CUSTOMER][NEUTRAL] Gastro Health LLC.
[AGENT][NEUTRAL] Alright, so I'm not showing a claim on file for for [PII] from Gastro Health or with your total bills.
[CUSTOMER][NEUTRAL] OK, no claim, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Yeah, just a moment. Actually,
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mm, just a moment. OK. OK.
[CUSTOMER][NEUTRAL] Yeah, can I get the payer ID? Can you submit it electronically? Can you submit it electronically?
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Our pay ID is 60.
[CUSTOMER][NEUTRAL] Yeah, what is the pay?
[AGENT][NEUTRAL] Our payer ID is 60801.
[CUSTOMER][NEUTRAL] Yeah, can I get the mailing address?
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] The zip code is [PII].
[CUSTOMER][NEUTRAL] Just a moment.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And also can you please uh tell me the patient effective date and termination date.
[AGENT][NEUTRAL] Hold on one moment.
[CUSTOMER][NEUTRAL] Yeah, OK, sure. Take it down.
[AGENT][NEUTRAL] The policy is still active. It's been effective since [PII].
[CUSTOMER][NEUTRAL] Just a moment.
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] [PII]. OK. I still like to, uh.
[CUSTOMER][NEUTRAL] What is the timely failing to submit the claim?
[AGENT][NEUTRAL] Um, there's no timely filing as long as the policy is active on the data service, you can file at any time.
[CUSTOMER][NEUTRAL] Yeah, there is no time limit, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Just a moment.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, OK, can I get the call this number?
[AGENT][NEUTRAL] Sure, so there's no call reference number, but you can use my name in today's date. The first initial to my last name is.
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] Can you please spell your
[AGENT][NEUTRAL] I'm sorry, go ahead.
[CUSTOMER][NEUTRAL] Yeah, go ahead.
[CUSTOMER][NEUTRAL] Can you please spell your, uh, what is your name and what is your last name?
[AGENT][NEUTRAL] My name is
[AGENT][NEUTRAL] My name is [PII] The [PII] [PII].
[CUSTOMER][POSITIVE] Yeah, OK, [PII]. Thank you for assisting me. Have a great day. Bye-bye.
[AGENT][POSITIVE] You're welcome. Was there anything else I can assist you with today?
[CUSTOMER][POSITIVE] No, [PII], thank you.
[AGENT][POSITIVE] Alright, thanks for calling APL. Bye-bye.