AccountId: 011433970860
ContactId: 8ca3f55e-dd7d-4d84-8e92-6206c06a48b7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 348980 ms
Total Talk Time (AGENT): 82279 ms
Total Talk Time (CUSTOMER): 135680 ms
Interruptions: 1
Overall Sentiment: AGENT=0.1, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/15/8ca3f55e-dd7d-4d84-8e92-6206c06a48b7_20250515T15:28_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. This is [PII] from the provider's office. How are you doing today? Happy Thursday.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I'm doing fine. How are you, [PII]?
[CUSTOMER][POSITIVE] I'm good thank you so much for asking.
[AGENT][POSITIVE] How can I help you today?
[CUSTOMER][NEUTRAL] Uh, actually, for today, I do have a member on my file for which the claim has been crossed over to you through the Medicare. So, I was just looking on that particular status. Could you please help me?
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I do apologize, not from Medicare.
[CUSTOMER][NEUTRAL] It is not crossed over. We have resubmitted this particular claim with the Prime repair EOP. I do apologize.
[AGENT][NEUTRAL] OK. Do you
[AGENT][POSITIVE] You have a phone number I can get in case we get disconnected I can call you back?
[CUSTOMER][NEUTRAL] OK. The phone number is [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And do you have the policy number?
[CUSTOMER][NEUTRAL] I do have that number is 945137.
[CUSTOMER][NEUTRAL] Well, maybe I mean
[AGENT][NEUTRAL] Hold on one moment, please.
[CUSTOMER][POSITIVE] Take your time, please.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Um
[AGENT][NEUTRAL] And what's the patient's name?
[CUSTOMER][NEUTRAL] Patient's name is [PII]. Last name will be [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Thank you, [PII], you were just needing claim status?
[CUSTOMER][NEUTRAL] Sure, yes.
[AGENT][NEUTRAL] OK, I can help you with that. What data service was it for?
[CUSTOMER][NEUTRAL] It is for the date of service, [PII]. And the total charge amount is $16.50.
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEUTRAL] All right.
[AGENT][NEUTRAL] And that was 221, 25.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And that was for [PII], correct?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] I'm not sure we ever received that data service.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Let me double check. Just a second.
[CUSTOMER][NEUTRAL] OK. Uh, is it possible to check at your, uh, like on at your system that we have submitted this on [PII]? Did you receive any claim, like, uh, any claim, like, uh, even a rejection, uh, in your system?
[AGENT][NEGATIVE] No, ma'am. We haven't we have not received it at all.
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] Can I know whether the member was active on the data service?
[AGENT][NEUTRAL] Yes, it was active.
[CUSTOMER][NEUTRAL] What is the time filing limit to submit the claim?
[AGENT][NEGATIVE] We do not have timely filing.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And what is the fax number and the mailing address in which we can uh resubmit the claim?
[AGENT][NEUTRAL] The fax number is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] The address
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the payer ID would be 60801.
[CUSTOMER][NEUTRAL] Uh OK. Uh, once again, can you please repeat the fax number is [PII]?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK. Attention.
[AGENT][NEUTRAL] Claims.
[CUSTOMER][NEUTRAL] For both? Uh mailing and the uh fax?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Got you. Thank you. Can I have the caller reference number?
[AGENT][NEUTRAL] We do not have reference numbers you can use my name in today's date.
[CUSTOMER][NEUTRAL] OK, got you. Can I have the initial of your last name, [PII], please?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] OK, great. Thank you so much, [PII]. Have a great rest of your day. Bye-bye. Take care.
[AGENT][POSITIVE] Thank you, [PII], for calling APL. You as well. Bye-bye.
[CUSTOMER][NEUTRAL] Bye.