AccountId: 011433970860
ContactId: 9786f350-71f0-4dc8-9642-a1b3c3127725
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 212729 ms
Total Talk Time (AGENT): 88212 ms
Total Talk Time (CUSTOMER): 96016 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/11/9786f350-71f0-4dc8-9642-a1b3c3127725_20250311T14:55_UTC.wav
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[AGENT][POSITIVE] Good morning. Thanks for calling APL. This is may I help you?
[CUSTOMER][NEUTRAL] Yeah, hi, uh, my name is [PII] and I'm calling from provider's office to check, uh, claim status for a member.
[AGENT][NEUTRAL] OK, I can verify claim status for you. [PII], and what is that policy number, please?
[CUSTOMER][NEUTRAL] Yeah, the numbers uh policy number is.
[CUSTOMER][NEUTRAL] 60801.
[AGENT][NEUTRAL] No, sir. That's not a policy number, that's a payer ID number. Do you have a copy of the card in front of you?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, do you see a policy cert number or in-hospital outpatient benefit cert number?
[CUSTOMER][NEUTRAL] Uh yes, I got it. Uh, let me provide you that. It's 02331548.
[CUSTOMER][NEUTRAL] M as in Mary, L as in Lima, number 8.
[AGENT][NEUTRAL] OK, thank you. And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] Yeah, it's [PII]. It's a direct line.
[AGENT][NEUTRAL] OK, and verify the patient's name, date of birth.
[CUSTOMER][NEUTRAL] Member's name is [PII], and the date of birth is [PII].
[AGENT][POSITIVE] OK, thank you so much. And you say you're calling for a claim status, correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And what was that data service and amount of the charge?
[CUSTOMER][NEUTRAL] Yeah, the date of service is [PII], and the bill amount is $139 even. It's $139.
[AGENT][NEUTRAL] OK. Thank you. And do you have a balance after primary insurance has processed the claim?
[CUSTOMER][NEUTRAL] Um, yes, that's a balance of $45.92.
[AGENT][NEUTRAL] OK. I don't show we received that claim. Can you verify the mailing address it was submitted to?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Um, yeah, sure, uh, we have submitted the claim to just a moment.
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, that is the correct address. If you like, I can give you our mailing address if you like to fax the claim. Oh wait, um, give me a moment. What's the name of the provider's office?
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Uh, it's Dermatology Associates of Sarasota.
[AGENT][NEUTRAL] OK. Well, I apologize, I take it back. It looks like we just received that claim on [PII] and it is in line for processing.
[CUSTOMER][NEUTRAL] OK, got it.
[CUSTOMER][NEUTRAL] Uh, can I have the claim number which is still in process?
[AGENT][NEUTRAL] There is no it's in line for processing, so it hasn't been processed yet.
[CUSTOMER][NEUTRAL] OK, got it. So can I get the turn around time for this claim to be processed?
[AGENT][NEUTRAL] Uh, usually from the time a claim is received, it can take 7 to 10 business days.
[CUSTOMER][NEUTRAL] OK, got it.
[CUSTOMER][NEUTRAL] OK, got it. Uh, that's it from my end. Can I get your name one more time and call reference number?
[AGENT][NEUTRAL] Uh, we don't give reference numbers, but you may use my name at today's date, and my name is [PII], spelled [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Yeah. Thank you, [PII]. Have a great day. Bye.
[AGENT][POSITIVE] You're welcome, [PII]. Thank you for calling APL. Bye.
[CUSTOMER][NEUTRAL] Mhm.