AccountId: 011433970860
ContactId: 8b3a1e62-0bd6-40b4-98be-5a620aa58f5c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 266929 ms
Total Talk Time (AGENT): 155979 ms
Total Talk Time (CUSTOMER): 93391 ms
Interruptions: 1
Overall Sentiment: AGENT=1, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/21/8b3a1e62-0bd6-40b4-98be-5a620aa58f5c_20250221T18:22_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], I was calling for one of your members just got off the phone with. I just needed to verify information and how can I send this claim as fast as possible because she's been making payments and the claim is back on [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so you're wanting.
[CUSTOMER][NEUTRAL] Would it cause any kind of timely filing?
[AGENT][NEUTRAL] OK, so you're wanting to find out about filing a claim for a patient for a data service back in [PII], correct?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] [PII], uh, uh-huh, uh-huh mhm.
[AGENT][POSITIVE] Yes, ma'am. I can help you with all of that. So first off, who am I speaking with?
[CUSTOMER][NEUTRAL] It's [PII]
[AGENT][NEUTRAL] [PII], OK, thank you. And [PII], what is your callback number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and the member's policy number please, [PII].
[CUSTOMER][NEUTRAL] She gave me 023 04196 ML 8.
[AGENT][POSITIVE] OK, thank you. Give me a couple of moments please to get the member's information pulled up.
[CUSTOMER][POSITIVE] OK alright thank you.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] 8,089,080.
[CUSTOMER][NEUTRAL] There
[AGENT][NEUTRAL] OK, so, uh, any information, [PII] that I provide for you today will be a verification of benefits and not a guarantee of payment. What is your patient's name please and their date of birth?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It is for um.
[CUSTOMER][NEUTRAL] Girl, I just got the lady name. Her name is [PII].
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Let me go back to the claim again because I moved out. [PII] date of birth is [PII].
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] OK, thank you. So yes ma'am, she is the subscriber on the supplemental policy and the supplemental policy is active with an effective date of [PII].
[AGENT][NEUTRAL] And it's still active. There is no termination date.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so can I fax this claim over because it's like an emergency for her because she's been making payments.
[AGENT][NEUTRAL] Uh, you can you can fax it, and it does take about 24 hours or so for us to be able to have it fully processed and on her profile to be in line for review, but yes ma'am, you can fax it now because this is a, yeah, I'll give you the fax number, [PII] now you will also need to send us a copy of her primary insurance company's explanation of benefits as well.
[CUSTOMER][POSITIVE] Not a problem. Mhm. OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Because we do have to have that when reviewing uh a claim on this type of policy, the fax number that you can send those to is [PII] Attention claims.
[CUSTOMER][NEUTRAL] I will.
[CUSTOMER][NEUTRAL] Oh yeah, oh yeah.
[CUSTOMER][NEUTRAL] Oh yeah.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, OK.
[AGENT][NEGATIVE] And there is no timely, I believe you also asked something about timely filing. We do not have a timely filing. Yes, ma'am, there is no timely filing with APL.
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] Yes, I did.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Perfect working on this right now thank you [PII] is there a reference number?
[AGENT][NEUTRAL] Well, you're welcome. Yes ma'am. There is you would use my name in today's date, [PII], and one additional piece of information. Once we have processed the claim at APL, we do have a portal that you should be able to check claim status and have access to our EOB and the portal website that you would go to is secured.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] Lovely.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Secured AMP.
[CUSTOMER][NEUTRAL] Public
[AGENT][NEUTRAL] OK. After secured, you'll need to put a [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] [PII], OK, [PII]. Got it. Got you. Do I have to register?
[AGENT][NEUTRAL] Yes, ma'am. Uh-huh.
[AGENT][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] You do. It's a self-registering portal, but you would just follow the steps and answer the questions. Yes, ma'am.
[CUSTOMER][NEUTRAL] OK. OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Oh OK perfect thanks [PII] have a great weekend thank you.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Well, I hope you have a great weekend too, and if that's all I can help you with, thank you again for calling APL.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] Alright have a great day bye bye.
[AGENT][POSITIVE] Yes ma'am, you too. Bye bye.
[CUSTOMER][POSITIVE] Thank you.