AccountId: 011433970860
ContactId: 837cd36c-7c5e-4f04-8f16-1991dd184695
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 457290 ms
Total Talk Time (AGENT): 169530 ms
Total Talk Time (CUSTOMER): 218103 ms
Interruptions: 5
Overall Sentiment: AGENT=0.7, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/27/837cd36c-7c5e-4f04-8f16-1991dd184695_20250527T17:37_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII] calling for the office to check on the claim status. Please be informed that this call may be recorded for quality assurance and training purposes.
[AGENT][NEUTRAL] OK, [PII], so you're calling for one claim status, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes, [PII], I can help you with that. And what is your callback number?
[CUSTOMER][NEUTRAL] Sure, that's [PII].
[AGENT][NEUTRAL] I'm sorry.
[AGENT][NEUTRAL] [PII] and then give me the rest of it again, please.
[CUSTOMER][NEUTRAL] Sure it's [PII].
[AGENT][NEUTRAL] Thank you. And [PII], what is your mem uh the patient's policy number?
[CUSTOMER][NEUTRAL] Sure, that is 021.
[CUSTOMER][NEUTRAL] 565.
[CUSTOMER][NEUTRAL] 11.
[AGENT][POSITIVE] Thank you. One moment, please.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] like they never.
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] that's the one I think.
[CUSTOMER][NEUTRAL] Hello, uh, uh, come on equipment come here.
[CUSTOMER][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] On the information that that I do provide will be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] Sure, the patient's name is uh [PII] and the date of birth of [PII].
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] And the date of service and total bill amount, please?
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] Sure, that is uh [PII].
[CUSTOMER][NEUTRAL] With a total of $7,801.80.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] so
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] I think they
[CUSTOMER][NEUTRAL] And.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah right.
[AGENT][NEUTRAL] OK, and you said that the total bill amount is $7,801.80 for data service 34 2024. Is that correct?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] You got it.
[AGENT][NEUTRAL] OK, we do not have a claim on file for this member for that data service and that build out.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] OK, uh, yeah, the, uh, may I get the patience, uh, if it your date and the term date.
[AGENT][NEUTRAL] The effective date is [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And the termination date on this policy, there is not, it's still showing this policy is active?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK, got it. And may I get the payer ID and the claim mailing address.
[AGENT][NEUTRAL] Yes, one moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, the payer ID is 60801.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I.
[AGENT][NEUTRAL] And you said that you also needed the claim's mailing address, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] That is [PII].
[AGENT][NEUTRAL] [PII] City, [PII].
[CUSTOMER][NEUTRAL] I'm
[AGENT][NEUTRAL] And the zip code is [PII].
[CUSTOMER][NEUTRAL] Yes
[AGENT][NEUTRAL] Attention claims department.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] And because this is a supplement to the primary insurance, we will have to also have a copy of the primary insurance company's explanation of benefits along with the claim for review.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then once we have processed.
[CUSTOMER][NEUTRAL] OK, the copy of the private.
[AGENT][NEUTRAL] Correct. And then once the claim has been processed here at APL Nick, we do have a portal that you should be able to check the claim status in, and the website for our portal is located at [PII].
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Hold on
[CUSTOMER][NEUTRAL] They
[CUSTOMER][POSITIVE] OK, [PII]
[AGENT][NEUTRAL] Mhm. [PII].
[CUSTOMER][POSITIVE] OK, OK, perfect.com.
[CUSTOMER][NEUTRAL] OK. Um, may I know the family planning limit?
[AGENT][NEGATIVE] There is no timely filing limit?
[CUSTOMER][NEUTRAL] OK, not to your fault. OK, got it.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK, OK, I just reconfirm the PO box and the payer ID. The payer ID is 60801 and the mailing address PO box is [PII].
[AGENT][NEUTRAL] No, 950.
[CUSTOMER][NEUTRAL] OK, 950.
[CUSTOMER][NEUTRAL] 9
[CUSTOMER][NEUTRAL] 248,950 and uh zip code is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] 50, yeah, that, yeah, that's the one I got it. I just I the zip code, yeah.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, [PII] and uh I get a call reference number.
[AGENT][NEUTRAL] And it would be my name along with today's date.
[CUSTOMER][NEUTRAL] OK, [PII].
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] Yes, please. I'm done with my questions and thank you so much for the information. And uh, uh, is there any fax number?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Well
[AGENT][NEUTRAL] [PII] attention claims department.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Oh my God, one moment, sorry for that. Uh, it's [PII].
[AGENT][NEUTRAL] 365.
[AGENT][NEUTRAL] 942-3. Attention claims department.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, 942-3 claims department. Yes, [PII], thank you so much for that also and have a great day. Bye for now.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Well, you're very welcome. And if that is all I can help you with, [PII], thank you again for calling APL and I hope you have a nice day as well.
[CUSTOMER][POSITIVE] Sure, thank you so much.
[AGENT][POSITIVE] You're welcome. Bye-bye.
[CUSTOMER][NEUTRAL] Bye.