AccountId: 011433970860
ContactId: 87b70c1d-2d0d-475e-b47b-06c4a6e66378
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 448630 ms
Total Talk Time (AGENT): 118577 ms
Total Talk Time (CUSTOMER): 119172 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/13/87b70c1d-2d0d-475e-b47b-06c4a6e66378_20250213T17:42_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling for Springfield Clinic LLP. Please note this call is being recorded and monitored for quality and training purposes. I'm calling to check claim status.
[AGENT][NEUTRAL] OK, sure, yes, I can assist you with claim status, and may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII], no extension.
[AGENT][NEUTRAL] OK, and may I have the patient's policy number?
[CUSTOMER][NEUTRAL] The policy number is 02505362.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Patient's name is [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you. And what is the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] The date of service is [PII] and the bill amount $510 even.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Let me see if I can find it. One moment.
[CUSTOMER][NEUTRAL] A
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] This is for dental?
[CUSTOMER][NEUTRAL] Just a second.
[CUSTOMER][NEUTRAL] I'm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] Medical.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, so let me pull the medical part.
[AGENT][NEUTRAL] And you said the date of service is [PII] or [PII]?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mm, OK.
[AGENT][NEUTRAL] I don't have a claim for [PII].
[CUSTOMER][NEUTRAL] For the bill amount of $510.
[AGENT][NEUTRAL] What is the procedure code?
[CUSTOMER][NEUTRAL] Procedure code is the second.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 99239.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] No, we don't have that claim on file.
[CUSTOMER][NEUTRAL] OK. So, may I know the patient's eligibility?
[AGENT][NEUTRAL] Uh, sure.
[CUSTOMER][POSITIVE] Effective on the term date.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes. Um, the policy was active, um, [PII] and it terminated [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Of [PII].
[AGENT][NEUTRAL] [PII]. Mhm.
[CUSTOMER][NEUTRAL] OK. Are you primary or secondary for the patient?
[AGENT][NEUTRAL] This was a limited policy, so it's not a primary or secondary. This is a limited policy.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Just a second.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] May I know the claim mailing address?
[AGENT][NEUTRAL] Oh, sure. For this one in particular, let's see, one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] We have IMA and that's [PII].
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm, yes.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] What
[CUSTOMER][NEUTRAL] So the [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Yes, that is correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Could you tell me the time if I need a minute?
[AGENT][NEUTRAL] We don't have company filing limits.
[CUSTOMER][NEUTRAL] And is there any payer ID?
[AGENT][NEUTRAL] Mm, yeah, let me go back to it. One moment.
[AGENT][NEUTRAL] Payer ID is 64556.
[CUSTOMER][NEUTRAL] 645-556.
[AGENT][NEUTRAL] 645-556.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] We accept electronic and paper submission.
[AGENT][NEUTRAL] Yes, it's either electronic or by mail.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] Thank you. Could you once say your name?
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] My name is [PII]. That's [PII]. That's initial [PII].
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Could you give me the reference number for this call?
[AGENT][NEUTRAL] We don't have reference numbers you can use my name in today's date.
[CUSTOMER][POSITIVE] OK. Thank you sir for your assistance in this call. Have a nice day.
[AGENT][POSITIVE] You as well and thank you for calling APL bye bye.