AccountId: 011433970860
ContactId: 884a673a-4296-4410-ab12-94e0b4a68208
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 379790 ms
Total Talk Time (AGENT): 186665 ms
Total Talk Time (CUSTOMER): 112796 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/16/884a673a-4296-4410-ab12-94e0b4a68208_20250416T15:16_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh, hi, this is [PII] calling from provider's office to check on claims.
[AGENT][NEUTRAL] OK, I'm sorry. Can you spell your name for me, please?
[CUSTOMER][NEUTRAL] Oh yeah, that is [PII]. Last initial is [PII]. Uh, can you spell your name too?
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, [PII], and your callback number, please.
[CUSTOMER][NEUTRAL] Oh yeah, that is [PII].
[AGENT][NEUTRAL] Thank you. And the member's policy number, please?
[CUSTOMER][NEUTRAL] Uh, yeah, but before we proceed, I would like to inform you that this call is being recorded for training and quality purpose. So are you OK with that?
[AGENT][NEUTRAL] That is fine.
[CUSTOMER][NEUTRAL] OK, thank you. Policy number is 018.
[CUSTOMER][NEUTRAL] 41076
[AGENT][POSITIVE] OK, thank you. And how can I help you today, [PII]?
[CUSTOMER][NEUTRAL] Uh, regarding claims actually.
[AGENT][NEUTRAL] You're needing claim status, is that correct?
[CUSTOMER][NEUTRAL] Yeah, claim status.
[AGENT][NEUTRAL] Yes, ma'am, I can help you with that, and any information that I do provide for you will be a verification of benefits and not a guarantee of payment. What is your patient's name, please, and date of birth?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] And again, any information that is provided would be a verification of benefits and not a guarantee of payment. What is the data service and total bill amount, please?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, date of service is [PII]. Bill amount is $185.83.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, so there is no claim on file on this policy number. This policy was not active for your data service. This policy had an effective date on it of [PII].
[AGENT][NEUTRAL] So 1120 [PII].
[AGENT][NEUTRAL] There is another policy number that I need to give you that's the correct policy.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 02502637 with an effective date of [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And give me a moment to see if the claim was processed under the correct policy number.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh no, ma'am, we do not have the claim on file under the correct policy number either.
[CUSTOMER][NEUTRAL] OK. So the claim, sorry, ID which you have given is 02502637 and that is active for the rate of service, right?
[AGENT][NEUTRAL] That is correct for, yes. As I stated, this policy's effective date is [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. Uh, can you confirm the address where we have built the claim?
[AGENT][NEUTRAL] Yes, ma'am. What address do you have?
[CUSTOMER][NEUTRAL] Uh, that is [PII]. Is it correct?
[AGENT][NEUTRAL] No, ma'am.
[AGENT][NEUTRAL] Uh, I have, no, ma'am, that is not correct for APL. I don't know whose address that is.
[CUSTOMER][NEUTRAL] Mm, OK. Can you give me the address of payer ID?
[AGENT][NEUTRAL] Our claims mailing address is [PII].
[AGENT][NEUTRAL] That's [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] The zip code is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And the payer ID is 60801.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And because this is a supplemental policy to her primary insurance, we must also receive a copy of the primary insurance company's explanation of benefits.
[AGENT][NEUTRAL] As well as the claim for review.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] All right. Uh, we can, primary will be, we can fax it, right?
[AGENT][NEUTRAL] You can fax it the claim in that explanation of benefits may be faxed to [PII].
[AGENT][NEUTRAL] 3659423. Attention claims.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. Uh, all right, then. Uh, can I have reference number, please?
[AGENT][NEUTRAL] You would use my name along with today's date.
[CUSTOMER][POSITIVE] All right then. OK. Thank you so much. Have a great day.
[AGENT][NEUTRAL] OK, well, you're welcome, [PII]. Yes, and one last thing, [PII], once we process the claim here at APL, we have a portal that you should be able to check our claim status in, and the website for our portal is secured.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm, OK.
[AGENT][NEUTRAL] OK. And is there anything else that I can help you with today?
[CUSTOMER][POSITIVE] Oh, nothing. Thank you so much.
[AGENT][POSITIVE] OK. Well, you're welcome and thank you again for calling APL. I hope you have a nice day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thank you. Bye-bye.