AccountId: 011433970860
ContactId: 90e4663a-5292-43b6-9bb1-d8773f12f9e4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 380950 ms
Total Talk Time (AGENT): 132417 ms
Total Talk Time (CUSTOMER): 114038 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/03/90e4663a-5292-43b6-9bb1-d8773f12f9e4_20250203T15:12_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yeah, hi, this is [PII] and I'm calling from the provider's office.
[AGENT][NEUTRAL] I'm sorry, you said your name was [PII].
[CUSTOMER][POSITIVE] Yes, that's correct.
[AGENT][NEUTRAL] OK, uh, [PII], can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] Uh sure. It's [PII].
[AGENT][POSITIVE] OK, thank you and what can we help you with today?
[CUSTOMER][NEUTRAL] Uh, yeah, so I'm calling in regards to members eligibility status.
[AGENT][NEUTRAL] OK, yeah, I can check eligibility for you. Uh, do you have the policy number?
[CUSTOMER][NEUTRAL] Uh yes, it's 02502.
[CUSTOMER][NEUTRAL] 424 M as in Mary, L as in Lima number 8.
[AGENT][NEUTRAL] Alright thank you and what was the name and date of birth for the insured?
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] And the date of birth is [PII].
[AGENT][NEUTRAL] Alright, thank you for verifying that, [PII]. Uh, so this policy is active. Effective date was [PII], and this is a secondary medical policy, so it is designed to help with co-pay, deductible and co-insurance after major medical pays.
[CUSTOMER][NEUTRAL] It's a secondary policy, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Will you be able to help me with the claim status?
[AGENT][NEUTRAL] For uh this number for [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yeah, what was the date of service for that claim?
[CUSTOMER][NEUTRAL] And what's the
[CUSTOMER][NEUTRAL] Uh, I had a question like what's the payer's name?
[AGENT][NEUTRAL] Uh, [PII] is the, uh, are you talking about the primary on the, the, this policy, the policy holder?
[CUSTOMER][NEUTRAL] Yes, uh, the, no, the policy, yeah. So what's the secondary plan name?
[AGENT][NEUTRAL] That is [PII].
[AGENT][NEUTRAL] Oh, it's Medlink
[CUSTOMER][NEUTRAL] It's Medlink.
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] Yes, so I'll provide you the details sir.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] It's
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Can you build them out, please?
[CUSTOMER][NEUTRAL] Oh, yeah.
[CUSTOMER][NEUTRAL] Did you get the data of service?
[AGENT][NEUTRAL] What was the bill amount please?
[CUSTOMER][NEUTRAL] It's $2530 even.
[AGENT][NEUTRAL] Could you repeat that, [PII]? I'm sorry.
[CUSTOMER][NEUTRAL] It's $2530 even.
[AGENT][NEUTRAL] 2520.
[CUSTOMER][NEUTRAL] 30, 3030.
[AGENT][NEUTRAL] OK thank you one moment.
[AGENT][NEUTRAL] Uh, [PII], what was the name of the, uh, provider's office?
[CUSTOMER][NEGATIVE] It's SMH physician Services.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] Do you happen to have that tax ID, [PII]?
[CUSTOMER][NEUTRAL] Uh yes, I do have the tax ID. It's [PII].
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] OK, so we did not receive that claim, [PII].
[CUSTOMER][NEUTRAL] And can you help me with the uh mailing address and the pay ID for claim submission?
[AGENT][NEUTRAL] Of course we've got a fax number as well if you'd like that uh the mailing address is, yes, mailing address is [PII].
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And that is in [PII].
[AGENT][NEUTRAL] Zip code is [PII].
[CUSTOMER][NEUTRAL] And what would be the pay ID?
[AGENT][NEUTRAL] He ID is [PII].
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] And what's the fax number?
[AGENT][NEUTRAL] Fax number is [PII].
[AGENT][NEUTRAL] 365.
[AGENT][NEUTRAL] 942 3.
[CUSTOMER][NEUTRAL] And I have one more question. So the secondary is not a Medicare supplement policy, right?
[AGENT][NEUTRAL] It's not I'm sorry, could you repeat that?
[CUSTOMER][NEUTRAL] So, the secondary insurance is not a Medicaid supplement policy.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Not Medicare, no, it is a supplemental policy, but it uh is off of major medical.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And you said the secondary payer name is Medli, right?
[AGENT][NEUTRAL] Right with uh this is APL, so American Public Life, the plan name is Medlink.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, so that's all for today. Can you help me with your first name and your last name, sir?
[AGENT][NEUTRAL] Yes, it's [PII].
[AGENT][NEUTRAL] Last initial is [PII] Was there anything else I could help you with, [PII]?
[CUSTOMER][NEUTRAL] And yeah, so what's the timely filing limit for claims permission?
[AGENT][NEGATIVE] There is no timely filing limit.
[CUSTOMER][NEUTRAL] Uh, that's all for today. You can provide the reference number.
[AGENT][NEUTRAL] Reference number would just be my first name, last initial, and today's date.
[CUSTOMER][POSITIVE] Sure. So that's all for today. Thank you for your time.
[AGENT][POSITIVE] OK, yeah, thanks for calling APL. I hope you have a great rest of your day.
[CUSTOMER][NEUTRAL] You too.
[AGENT][POSITIVE] Thank you bye bye.