AccountId: 011433970860
ContactId: 8d3155ed-f0df-4e8c-bcd8-b348b53621f8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 325799 ms
Total Talk Time (AGENT): 109127 ms
Total Talk Time (CUSTOMER): 113784 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/11/8d3155ed-f0df-4e8c-bcd8-b348b53621f8_20250611T19:14_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from the provider's office, and I'm calling for claim status.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Mm, sure, I can assist you with claim status, Mr. [PII]. May I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Yes, callback number is [PII].
[AGENT][NEUTRAL] OK, and may I have the name of the facility you're calling from for my notes?
[CUSTOMER][NEUTRAL] Name is uh Our Lady of the Lake physician group.
[CUSTOMER][NEUTRAL] that was that.
[AGENT][NEUTRAL] OK, and may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Patient policy number is.
[CUSTOMER][NEUTRAL] It's uh A as in Alpha, E as in Echo, 1153.
[AGENT][NEUTRAL] OK, that's not our policy number. Do you have the copy of the card?
[CUSTOMER][NEUTRAL] Let me see.
[CUSTOMER][NEUTRAL] Is it 83523?
[AGENT][NEUTRAL] 83523 um that.
[AGENT][NEUTRAL] That a bit too long to be a group number um.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] No, do you have a claim number or a social or anything like that that we can use?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yes, I do have a member's social number. Social security number is [PII].
[AGENT][POSITIVE] OK. Thank you.
[AGENT][NEUTRAL] Um
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] What's the name of the patient?
[CUSTOMER][NEUTRAL] Name is
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][NEUTRAL] OK, and what is her date of birth?
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you. What is the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] Data services [PII] and total charge amount is $54 even.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, [PII]. Is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It
[AGENT][NEUTRAL] And you said it's $54?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] Yes, that is correct.
[AGENT][NEUTRAL] What is the procedure code?
[CUSTOMER][NEUTRAL] Procedure code is 93,000.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] I don't see that claim on file, Mr. [PII].
[CUSTOMER][NEUTRAL] OK, what is the mailing address and the pay ID?
[AGENT][NEUTRAL] OK, the mailing address is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The zip code is [PII].
[AGENT][NEUTRAL] The payer ID is 60801.
[CUSTOMER][NEUTRAL] And payer ID?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK, can you tell me this member's eligibility?
[AGENT][NEUTRAL] OK, yes. Mhm.
[AGENT][NEUTRAL] We have an effective date of [PII] and it is active at the moment.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And what is the timely filing limit to submit a first claim?
[CUSTOMER][NEUTRAL] You
[AGENT][NEUTRAL] We don't have time limits.
[CUSTOMER][NEUTRAL] I don't
[CUSTOMER][NEUTRAL] DSL. OK. And is there a fax number where I can send the claim form?
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] Yes, [PII].
[CUSTOMER][NEUTRAL] And that's
[CUSTOMER][NEUTRAL] Alright, that's all I needed. Can I have your name again and the call reference?
[AGENT][NEUTRAL] My name is [PII]. That's [PII].
[CUSTOMER][NEUTRAL] Mhm. And what will be the call reference?
[AGENT][NEUTRAL] We don't have reference numbers you can use my name in today's date.
[CUSTOMER][POSITIVE] All right. So thank you so much for your help. I hope you have a great rest of your day.
[AGENT][POSITIVE] You as well thank you for calling APL. Bye-bye.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Bye.