AccountId: 011433970860
ContactId: 8901891d-b42b-44f4-9bdf-395a22f7363f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 475839 ms
Total Talk Time (AGENT): 135299 ms
Total Talk Time (CUSTOMER): 231268 ms
Interruptions: 5
Overall Sentiment: AGENT=0, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/31/8901891d-b42b-44f4-9bdf-395a22f7363f_20250131T19:59_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Hi, [PII]. This is [PII] calling for the provider to check on the status of a client. And could you please spell your name for me?
[AGENT][NEUTRAL] Yeah, it's [PII]
[AGENT][NEUTRAL] And I can check on a claim for you. [PII], can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure. It's going to be [PII] was a direct line.
[AGENT][NEUTRAL] Thank you. And then do you have the policy number?
[CUSTOMER][NEUTRAL] And then you have the
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah, yeah, just give me one moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK, your policy number is going to be, uh, just one second. It's 0249.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] 8570.
[CUSTOMER][NEUTRAL] 02498570
[AGENT][NEUTRAL] Got it thank you and what was the name and date of birth for the insured?
[CUSTOMER][NEUTRAL] It's [PII]. It's [PII] Date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you for verifying that [PII] and what was the date of service for this claim?
[CUSTOMER][NEUTRAL] Yeah, it's [PII].
[CUSTOMER][NEUTRAL] For the bill amount of $555 even.
[AGENT][NEUTRAL] 555.
[CUSTOMER][NEUTRAL] Yeah, 555.
[AGENT][NEUTRAL] OK thank you one moment.
[CUSTOMER][NEUTRAL] I'm going.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] I have.
[CUSTOMER][NEUTRAL] Are you there?
[AGENT][NEUTRAL] Yes, one moment.
[CUSTOMER][NEUTRAL] I'm physician.
[AGENT][NEUTRAL] I'm sorry, [PII], what was the name of the provider's office that you're with?
[CUSTOMER][NEUTRAL] I got somebody.
[AGENT][NEUTRAL] Do you have that tax ID?
[CUSTOMER][NEUTRAL] Yeah, we have the tax ID. Just give me one second.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] She.
[AGENT][NEUTRAL] Give me just a moment. Um, that amount, the 555, was that before or after major medical paid?
[CUSTOMER][NEUTRAL] Yeah, uh, the BCBS paid after that.
[CUSTOMER][NEUTRAL] No, no, no. Uh, total bill amount was $555. No, no, no. $555 555 dollars has been, uh, total bill amount. And after the BCBS has been paid.
[AGENT][NEUTRAL] That's the amount after?
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] The leftover is $276.40. Do you have a claim on file?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so
[AGENT][NEUTRAL] We do not. I do not have that claim on file, [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] No issues. We can rebuild the claim, resubmit the claim to you. Can I get your mailing address to resubmit the claim, please?
[AGENT][NEUTRAL] Of course.
[AGENT][NEUTRAL] Yes, I've also got a fax number and a pair ID if you'd like [PII], um, our mailing address is [PII].
[CUSTOMER][NEUTRAL] You know, uh, mhm, mhm.
[AGENT][NEUTRAL] Yes [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm. Mhm.
[AGENT][NEUTRAL] And that is [PII], [PII]. Zip code is [PII].
[CUSTOMER][NEUTRAL] Mhm, mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Got it. And your pay ID please?
[AGENT][NEUTRAL] Her ID is 60801.
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] OK, got it and uh timely firing limit to submit a claim.
[AGENT][NEGATIVE] There is no timely filing limit.
[CUSTOMER][NEUTRAL] OK, one second.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And the patient affected it and it, please.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Uh, patient policy effective date and termination date.
[AGENT][NEUTRAL] Yes, the effective date was [PII] and it is currently active.
[CUSTOMER][NEUTRAL] OK, I just need to check on another claim for a different member. Can I get a call reference for this number?
[AGENT][NEUTRAL] The reference number would be the same for all of them, [PII], um, and then you did say that was for a different policy.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, give me just a moment I'll let you know when I'm ready.
[CUSTOMER][NEUTRAL] Uh, yeah, I think so. Let me, yeah, let me check if it's under the same patient or not. Just give me one moment, OK?
[AGENT][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] Yeah, it's under a different patient.
[AGENT][NEUTRAL] Different, OK, give me just a moment I'll let you know when I'm ready.
[CUSTOMER][NEUTRAL] Yeah, yeah.
[CUSTOMER][NEUTRAL] To
[AGENT][NEUTRAL] OK, and I am ready for that next policy number, [PII].
[CUSTOMER][NEUTRAL] OK, that's going to be 023893887.
[AGENT][NEUTRAL] OK, and then what was the name and date of birth for the insured?
[CUSTOMER][NEUTRAL] So, uh member name is going to be um [PII]. Date of birth was uh [PII].
[AGENT][NEUTRAL] OK, thank you for verifying that and uh what was the date of service please?
[CUSTOMER][NEUTRAL] Yeah, we have the date of service is [PII], which has the total bill amount is going to be um.
[CUSTOMER][NEUTRAL] It is $30. Even the leftover and total bill was 1 $148 even. And after that, BCB is paid, the leftover is going to be $30.
[AGENT][NEUTRAL] OK thank you one moment.
[CUSTOMER][NEUTRAL] Yeah, sure.
[AGENT][NEUTRAL] OK, just to clarify that was [PII], correct?
[CUSTOMER][NEUTRAL] For yeah, 4 $1,048 even.
[AGENT][NEUTRAL] OK, so we have not received any claims for that date of service for this number.
[CUSTOMER][NEUTRAL] OK, can I get a patient activate please?
[AGENT][NEUTRAL] Uh, yes, this, uh, effective date was [PII], and it is currently active.
[CUSTOMER][NEUTRAL] OK, sounds good. And also, uh, can you provide me the call reference number?
[AGENT][NEUTRAL] Reference number would be the same as the other or it's my first name, last in[PII] and today's date.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] So it is [PII] A RA last initial is A, yes, was there anything else I could help you with, [PII]?
[CUSTOMER][NEUTRAL] Can I get your last name, sir?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. And
[CUSTOMER][POSITIVE] No, thank you for asking the claim. Have a wonderful rest of your day and bye for now.
[AGENT][POSITIVE] OK, yeah, thanks for calling HPL. I hope you have a great weekend.