AccountId: 011433970860
ContactId: 8ad5db7f-dd2a-4c91-a218-977c601e2a2c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 459809 ms
Total Talk Time (AGENT): 150676 ms
Total Talk Time (CUSTOMER): 186726 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/16/8ad5db7f-dd2a-4c91-a218-977c601e2a2c_20250416T20:46_UTC.wav
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[CUSTOMER][NEUTRAL] That's a
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] [PII], how can I help you?
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from provider's office. I'm looking for a claim status.
[AGENT][NEUTRAL] What is your callback number please [PII]?
[CUSTOMER][NEUTRAL] It's uh [PII]. It's a direct line.
[AGENT][NEUTRAL] Thank you. And may I have the policy number?
[CUSTOMER][NEUTRAL] Uh, yeah, just a second. Let me get the policy number in my system.
[CUSTOMER][NEUTRAL] Please bear with me.
[CUSTOMER][NEUTRAL] OK, so the policy number is 02435030.
[AGENT][NEUTRAL] OK, to repeat and confirm, I have that as 02435030. Thank you.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] So the first name is uh [PII], the last name is [PII]. The date of uh
[CUSTOMER][NEUTRAL] But is uh [PII].
[AGENT][NEUTRAL] OK, verify the patient's name and date of birth again, please?
[CUSTOMER][NEUTRAL] Sure, it's, uh sorry, [PII]. Last name is [PII]. The date of birth, [PII].
[AGENT][POSITIVE] Thank you very much, and you're calling for claim status. I can assist you. What is that date of service and the total charge amount?
[CUSTOMER][NEUTRAL] Uh, uh.
[CUSTOMER][NEUTRAL] Uh, yeah, so the date of service is [PII] with the bill amount of $420 even.
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] OK, let me just repeat that. I have that as [PII] for $420 even.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] I did not show that claim on file.
[CUSTOMER][NEUTRAL] OK. Thank you. And I need, I need one more information for this. Uh, so the provider facility NPI is, uh, injured or not?
[CUSTOMER][NEUTRAL] With the American Public Life Insurance Company. Could you please check with that for me?
[AGENT][NEUTRAL] I'm sorry, if you could ask that question again?
[CUSTOMER][NEUTRAL] Yeah, sure.
[CUSTOMER][NEUTRAL] So the facility is enrolled with American Public Life Insurance, uh, or not. Could you please check with, check for me?
[AGENT][NEUTRAL] OK, we do not have a network of providers.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and then I can provide you with their mailing address, fax number, or payer ID to submit that claim since it is not on file.
[CUSTOMER][NEUTRAL] Uh, so can I get the
[CUSTOMER][NEUTRAL] Uh, policy effective the term.
[AGENT][NEUTRAL] OK, the policy was effective or is effective as of December excuse me, [PII], and this policy shows active.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And uh,
[CUSTOMER][NEUTRAL] Claim mailing address?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Just a second.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Would you like our payer ID and fax number as well?
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Yeah, you're gonna need to pay ID.
[AGENT][NEUTRAL] 60801.
[CUSTOMER][NEUTRAL] Fax number.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] 942 3.
[CUSTOMER][NEUTRAL] And uh can I get the timely for limit for submitting the claims?
[AGENT][NEUTRAL] OK, there is no time I falling to submit a claim, [PII]. You can also submit claims and check claim status on our secure website at [PII].
[CUSTOMER][NEUTRAL] So there is no specific, just a second.
[CUSTOMER][NEUTRAL] So there is no specific time limit, right?
[AGENT][NEUTRAL] That is correct. There is no timely filing.
[CUSTOMER][NEUTRAL] And what is the website [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK. OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And could you please hold for a moment? Let me get the
[CUSTOMER][NEUTRAL] Link in my system for provider registration.
[CUSTOMER][NEUTRAL] And uh so I will provide an NP number. You can check whether the provider is in-network or out of network.
[AGENT][NEUTRAL] There is no network for APL.
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] We do not have a provider's network. There's no network for APL.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So, what is the procedure for register the provider services?
[AGENT][NEUTRAL] The provider would just need to submit the claim to us either by mail, fax or electronically with our payer ID.
[CUSTOMER][NEUTRAL] No, no, no. No, I mean.
[CUSTOMER][NEUTRAL] I'm asking the provider registration with the portal.
[AGENT][NEUTRAL] OK, you will need to submit a claim first so you would need to create.
[AGENT][NEUTRAL] Actually give me 1 2nd.
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] So how we will get the provider enrollment status?
[AGENT][NEUTRAL] I'm so sorry, [PII], if you could please repeat that?
[CUSTOMER][NEUTRAL] Yeah, sure. So, what is the procedure?
[CUSTOMER][NEUTRAL] Forge the
[CUSTOMER][NEUTRAL] Provide the enrollment status.
[AGENT][NEUTRAL] There is no procedure.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And uh so if you submit, submitting a claim through fax, is there any specific uh cover sheet and what are the documents you have to submit attach with for the claim?
[AGENT][NEUTRAL] OK, this is a 2 year or supplemental policy, so we would need the claim form, either the 1500 or the UBO4 along with the explanation of benefits from the primary.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] For the primary. OK.
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] Uh, so, can I get your name, can I get your name and call reference number for this?
[AGENT][NEUTRAL] My name is [PII]. We do not provide call reference numbers, but you can use my name in today's date. My last initial is [PII].
[CUSTOMER][NEUTRAL] Last, last initial [PII]?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] OK. OK.
[CUSTOMER][POSITIVE] Thank you, [PII]. Thanks for your help today and have a good rest of your day.
[AGENT][POSITIVE] You as well, [PII], and thank you for calling APL. Take care. Bye.
[CUSTOMER][NEUTRAL] Bye bye.