AccountId: 011433970860
ContactId: 9288dfbc-dc28-465d-874d-3f86ba59f415
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 273260 ms
Total Talk Time (AGENT): 111199 ms
Total Talk Time (CUSTOMER): 78841 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/12/9288dfbc-dc28-465d-874d-3f86ba59f415_20250212T22:28_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, my name's [PII]. I'm calling from Florida Hospital physician Group checking on the status of a claim, please.
[AGENT][POSITIVE] OK, well, I'll be more than happy to assist you with the claim status, [PII]. May I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you for that. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] 02556263
[CUSTOMER][NEUTRAL] M as in Michael, L as in Lima, and the number 7.
[AGENT][NEUTRAL] OK, I'm gonna repeat the policy number because it's kind of choppy. Um, you said 025562663, is that correct?
[CUSTOMER][NEUTRAL] And then after the 3 there's M as in Michael, L as in Lima, 7.
[AGENT][NEUTRAL] Thank you for that. And can you verify the member's first and last name and date of birth?
[CUSTOMER][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And may I have the date of service for the claim?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the total bill?
[CUSTOMER][NEUTRAL] $526.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] So for [PII], we um we don't have any claims on file for [PII].
[CUSTOMER][NEUTRAL] OK. Now, it looks like they mailed it to an American public life, but it went to a
[CUSTOMER][NEUTRAL] PO box in [PII], is that correct?
[AGENT][NEUTRAL] Um, that is our old claims mailing address. Let me give you the current claims mailing address.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] So it's [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] Zip code is [PII].
[CUSTOMER][NEUTRAL] OK, what's your timely filing limit?
[AGENT][NEUTRAL] So there's no timely filing limit as long as the policy is active on the data service, you can file the claim at any time. And let me check for this policy. Hold on one moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] This policy has been has been active since [PII], so it was active on the data service.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And do you show that it's secondary or primary?
[AGENT][NEUTRAL] Um, this is a secondary policy, we apply to the co-pay, deductible and co-insurance after primary.
[CUSTOMER][NEUTRAL] And do you need uh me to send a copy of the EOB as well from the primary?
[AGENT][NEUTRAL] Yes, the um explanation of benefits from primary, the itemized bill from the provider and the claim form.
[CUSTOMER][NEUTRAL] OK. And uh am I able to fax this?
[AGENT][NEUTRAL] Yes, um, you can fax it to [PII].
[AGENT][NEUTRAL] Um, 365.
[AGENT][NEUTRAL] 942 3.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] We have
[CUSTOMER][NEUTRAL] Uh, so if I fax a claim form that has the old address on it, will that be an issue, or does it need to have the claim on it?
[AGENT][NEUTRAL] Um, the claim form is from a provider is usually whatever your uh health claim form is.
[AGENT][NEUTRAL] But if you have an APL claim form, then it um we'll still process it. It's just an old form.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, thank you for checking that on this and what was your name? [PII], and do you do reference numbers?
[AGENT][NEUTRAL] So there's no call reference number, but you can use my name in today's date. The first initial to my last name is [PII].
[CUSTOMER][POSITIVE] Thank you so much you have a good rest of your day.
[AGENT][POSITIVE] You also, and thanks for calling APL. Bye bye [PII].
[CUSTOMER][POSITIVE] Thank you.