AccountId: 011433970860
ContactId: 84d5a320-ca04-4be2-ba97-1eeda0c26b0b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 400559 ms
Total Talk Time (AGENT): 111049 ms
Total Talk Time (CUSTOMER): 207521 ms
Interruptions: 5
Overall Sentiment: AGENT=0.1, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/28/84d5a320-ca04-4be2-ba97-1eeda0c26b0b_20250328T17:30_UTC.wav
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[AGENT][NEUTRAL] I have my sister.
[CUSTOMER][NEUTRAL] my wife.
[CUSTOMER][NEUTRAL] Hey.
[AGENT][NEUTRAL] Hello, thanks for calling APL. This is [PII]. How may I assist you?
[AGENT][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Hello, this is [PII] calling from provider's office regarding claim status.
[AGENT][POSITIVE] Sure, I can assist you with that. Can I have a callback number for you, Cookie?
[AGENT][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Yeah, it's [PII]. It's a direct line.
[AGENT][NEUTRAL] Your phone is going out.
[AGENT][NEUTRAL] And what is the policy number?
[CUSTOMER][NEUTRAL] Uh hello?
[CUSTOMER][NEUTRAL] Uh one moment before that, could you please share me to me.
[CUSTOMER][NEUTRAL] On each day.
[CUSTOMER][NEUTRAL] Uh hello.
[AGENT][NEUTRAL] The policy number of the member that you're calling to check the status of a claim for.
[CUSTOMER][NEUTRAL] Yeah, one moment, it's uh 02100152 M as in Mike L as in Lima 835.
[AGENT][NEUTRAL] Could you verify that patient's name and date of birth?
[CUSTOMER][NEUTRAL] The member's name is uh [PII] and the date of birth is [PII].
[AGENT][NEGATIVE] And you said your name was Cookie, Cookie, I can barely hear you and the background is loud. And each time I ask you a question, it sounds like you're putting me on mute or something. I'm not sure.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Give me, give me, give me a second.
[CUSTOMER][NEUTRAL] Give me a moment.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] When I you.
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Yes, could you repeat her date of birth?
[CUSTOMER][NEUTRAL] Hello? No.
[CUSTOMER][NEUTRAL] Yeah, sure, it's [PII].
[AGENT][NEUTRAL] [PII] who?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] [PII]. It's [PII].
[AGENT][NEUTRAL] And what is the date of service that you're calling to check the status of a claim for?
[CUSTOMER][NEUTRAL] Um, the service is [PII].
[CUSTOMER][NEUTRAL] Could you please spell your name for me?
[AGENT][NEUTRAL] You said [PII]?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And what is your procedure code?
[CUSTOMER][NEUTRAL] Uh, there are two procedures code. It's 9921420611 J 3301.
[AGENT][NEUTRAL] So it's 3 of them.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Can you verify how you submitted this claim to us? Because I'm not showing the claim on file.
[CUSTOMER][NEUTRAL] Uh, could you please repeat your name for me?
[CUSTOMER][NEUTRAL] Uh, we have submitted via mail.
[AGENT][NEUTRAL] And what is the address?
[CUSTOMER][NEUTRAL] I guess
[CUSTOMER][NEUTRAL] It's uh [PII], OK. [PII] [PII].
[AGENT][NEUTRAL] What was the mailing address?
[CUSTOMER][NEUTRAL] The mailing address is [PII].
[CUSTOMER][NEUTRAL] [PII], OK.
[AGENT][NEGATIVE] That's not correct.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] Uh, could you please sign?
[AGENT][NEUTRAL] [PII] is [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK you do [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm. Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And the
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And what is your bill amount?
[CUSTOMER][NEUTRAL] 312.
[CUSTOMER][NEUTRAL] It's um.
[CUSTOMER][NEUTRAL] One moment. It's $696.72.
[AGENT][NEUTRAL] Thank you. So there's no claim on file for the date of ser for the date of service.
[CUSTOMER][NEUTRAL] Uh, OK. Uh, uh, could you please spell out your name for me?
[AGENT][NEUTRAL] Yes, [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, could you please tell me the payer ID?
[AGENT][NEUTRAL] 60801.
[CUSTOMER][NEUTRAL] 60801. Could you please give me the effective dates of the member?
[CUSTOMER][NEUTRAL] 670
[AGENT][NEUTRAL] Give me one moment.
[CUSTOMER][NEUTRAL] Yeah sure.
[CUSTOMER][NEUTRAL] 32.
[CUSTOMER][NEUTRAL] now.
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] on.
[CUSTOMER][NEUTRAL] that.
[AGENT][POSITIVE] This policy became effective.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] 9.
[CUSTOMER][NEUTRAL] [PII] and it still active, right?
[AGENT][POSITIVE] Yes, that is correct.
[AGENT][POSITIVE] Yes, that is correct.
[CUSTOMER][NEUTRAL] Um, could you please tell me the TFL, yeah, could you please tell me the TFL to resubmit the claim?
[AGENT][NEUTRAL] Repeat your question.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Uh, could you please tell me the time you're filing to resubmit the claim?
[AGENT][NEGATIVE] There's no timely filing.
[CUSTOMER][NEUTRAL] When I
[CUSTOMER][NEUTRAL] OK, we can sub, right? There's no TSL.
[AGENT][NEGATIVE] No, there's no time to filing.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, could you please just uh give me the call reference number?
[AGENT][NEUTRAL] We don't provide those cookie, however, you can use my name in today's date as a reference.
[CUSTOMER][NEUTRAL] Yes
[AGENT][NEUTRAL] Would you like for me to provide you with the spelling of my name again?
[CUSTOMER][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Um, yeah, sure.
[AGENT][NEUTRAL] [PII], today's date.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Oh, OK, thank you so much.
[AGENT][POSITIVE] Thanks for calling APL and have a great day. Goodbye.
[CUSTOMER][POSITIVE] Have a great day.
[CUSTOMER][NEUTRAL] I got to pay.