AccountId: 011433970860
ContactId: 8b2c277d-9cfa-4ae0-b3af-55380df3288b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 434250 ms
Total Talk Time (AGENT): 139951 ms
Total Talk Time (CUSTOMER): 71830 ms
Interruptions: 2
Overall Sentiment: AGENT=0.8, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/30/8b2c277d-9cfa-4ae0-b3af-55380df3288b_20250130T14:27_UTC.wav
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[AGENT][NEUTRAL] And thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII]. I'm looking for the claim status.
[AGENT][NEUTRAL] OK, what was your name?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] OK, [PII] and you're needing claim status, is that correct?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][POSITIVE] Yes, I can help you with that, [PII]. What is your callback number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And the member's policy number, Max?
[CUSTOMER][NEUTRAL] Yeah, sure.
[CUSTOMER][NEUTRAL] Oh, it
[CUSTOMER][NEUTRAL] 244-857-2
[AGENT][NEUTRAL] OK. And do you only have this one claim to check status on?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, thank you, one moment.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, and [PII], any information that I do provide for you today will be a verification of benefits and not a guarantee of payment. What is your payment, excuse me, what is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] there
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK, what is your payment excuse me, what is your
[CUSTOMER][NEUTRAL] It's [PII] and the date of birth is [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And what is the date of service and total bill amount for her, please?
[CUSTOMER][NEUTRAL] [PII]. And the bill amount is
[CUSTOMER][NEUTRAL] $1,895.
[AGENT][NEUTRAL] $1,895. Is that correct?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] Just one moment, please.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] Excuse me, [PII], I'm sorry about that.
[CUSTOMER][NEUTRAL] Yeah, sure. It's OK.
[AGENT][NEUTRAL] OK, again, you said the total bill amount is $1,895?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me look at a few more claims. I'm not seeing that claim on file, just one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And what is the name of the provider?
[AGENT][NEUTRAL] Or the facility?
[AGENT][NEUTRAL] That you're calling on behalf of?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] North Shore Hematology oncology associate.
[AGENT][NEUTRAL] OK, so I do not see a single claim for this total bill amount of $1,895 [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And what is the address for the claim filing?
[AGENT][NEUTRAL] I'm sorry, what was your question?
[CUSTOMER][NEUTRAL] What is the address for the claim?
[AGENT][NEUTRAL] The mailing address for claims would be sent to IMA.
[AGENT][NEUTRAL] That is [PII].
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And the zip code is [PII], I'm sorry, the zip code is going to be [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And what is the TFL limit for the claim?
[AGENT][NEGATIVE] There is no timely filing limit.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then once we have received the claim and it has been processed, we do have a portal in which you can also check claim status and our portal website for that is secured.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] What is the card reference number?
[AGENT][NEUTRAL] My name along with today's date.
[CUSTOMER][NEUTRAL] May I know your name, please?
[AGENT][NEUTRAL] Again, my name is [PII]
[CUSTOMER][NEUTRAL] They are
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] OK. And last name?
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yes, and your last name initial?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] Thank you so much. Bye-bye. Have a good day.
[AGENT][POSITIVE] You're very welcome. OK, Mag, well that's all I can help you with. Thank you again for calling APO and I hope you have a nice day.
[CUSTOMER][NEUTRAL] Mhm.