AccountId: 011433970860
ContactId: 8ffe9834-49a2-4fe5-a1bb-13d0ff06bfc1
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 427899 ms
Total Talk Time (AGENT): 139728 ms
Total Talk Time (CUSTOMER): 112078 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/24/8ffe9834-49a2-4fe5-a1bb-13d0ff06bfc1_20250124T16:11_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hello, my name is [PII]. I'm calling from [PII] and I need to check claim status on a medical bill.
[AGENT][NEUTRAL] OK. And can I please get your first name again and the spelling?
[CUSTOMER][NEUTRAL] Sure, it's [PII]
[AGENT][POSITIVE] OK, Ms. [PII], thank you so much and I can help you with your claim status. Can you please give me your call back number just in case the call gets disconnected?
[CUSTOMER][NEUTRAL] Sure it's [PII].
[AGENT][NEUTRAL] Thank you, and then what is the patient's name?
[CUSTOMER][NEUTRAL] It's on [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK, and what is [PII]'s policy number?
[CUSTOMER][NEUTRAL] I have 02221070.
[AGENT][NEUTRAL] OK, let me pull that policy up for us real quick.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK and then um what is the data service for [PII]?
[CUSTOMER][NEUTRAL] It's 112 of 22.
[AGENT][NEUTRAL] Thank you. And what is the charge amount?
[CUSTOMER][NEUTRAL] It's for 39,401.
[CUSTOMER][NEUTRAL] And 98 cents.
[AGENT][NEUTRAL] OK, thank you. And then what is the charge amount after the primary insurance paid their part?
[CUSTOMER][NEUTRAL] Let's see right now there's a balance of $3,946.75.
[AGENT][NEUTRAL] OK, thank you, and you said you were with [PII], is that correct?
[CUSTOMER][NEUTRAL] Yes, yes, [PII].
[AGENT][NEUTRAL] OK, I'm gonna put you on a brief hold while I look up this claim for you and I'll be right back. Thank you for holding for me. You're welcome.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] OK. You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK Ms. [PII], this is [PII] back with you again. So looking on data service [PII], I do not find the claim on file.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Hm
[CUSTOMER][NEUTRAL] OK, let's see.
[CUSTOMER][NEUTRAL] OK, what is your filing deadline?
[AGENT][NEUTRAL] We don't have a timely filing limit as long as the insured was covered on the date of service you can file at any time.
[CUSTOMER][NEUTRAL] OK, let me see what this uh primary paid.
[CUSTOMER][NEUTRAL] I'm researching that right now.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, they paid on [PII].
[CUSTOMER][NEUTRAL] So, uh, I just wanna make sure that we're still in the, uh, timely filing. They have Aetna as primary. Do y'all have that in your system?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] Uh, I don't have his primary. I do show that the policy was effective from [PII] and then it lapsed on [PII].
[CUSTOMER][NEUTRAL] OK, so they were covered on [PII]?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And what is the claims address because we're sending it to an [PII].
[AGENT][NEUTRAL] Yes, that's correct, it's [PII] [PII].
[CUSTOMER][NEUTRAL] OK, is there a fax number?
[AGENT][NEUTRAL] We also have a payer ID. Yes, I was gonna tell you we have a payer ID and a fax number too if you wanna get it quicker, um, the payer ID is 60801.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, repeat that for me.
[AGENT][NEUTRAL] And then the fax number, [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then the fax number is 1877.
[AGENT][NEUTRAL] 365.
[AGENT][NEUTRAL] 942 3.
[CUSTOMER][NEUTRAL] OK great and [PII], what's the first initial of your last name?
[AGENT][NEUTRAL] It is [PII]
[CUSTOMER][NEUTRAL] Is there a reference number for today's call?
[AGENT][POSITIVE] Yes ma'am, you can use my name in today's date.
[CUSTOMER][NEUTRAL] OK, so you show no claim from [PII] on [PII], correct?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][POSITIVE] OK, all right, thanks for your help today.
[AGENT][POSITIVE] You're welcome you have a good weekend and thanks for calling APL.
[CUSTOMER][NEUTRAL] You too bye bye.