AccountId: 011433970860
ContactId: 97a2e9bb-f49e-4336-9f2e-432cdfcfae9e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 319480 ms
Total Talk Time (AGENT): 87592 ms
Total Talk Time (CUSTOMER): 103657 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/27/97a2e9bb-f49e-4336-9f2e-432cdfcfae9e_20250327T16:58_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Good afternoon. My name is [PII]. I'm calling from Proto's office, and I'm looking for claim fetus.
[AGENT][POSITIVE] OK, [PII], I'm happy to check on a claim for you today. Can I get the patient's policy number?
[CUSTOMER][NEUTRAL] Sure, sir. The patient's policy number is 02505763M as in Mary, L as in Lima 8.
[AGENT][POSITIVE] Thank you for that. And do you have a good call back number?
[CUSTOMER][NEUTRAL] Yes, that's [PII].
[AGENT][NEUTRAL] Thank you, [PII]. And then if I can get the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] Yes, sure. Patient's name is [PII] and her date of birth is.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you, data service.
[CUSTOMER][NEUTRAL] It was [PII] and the charge amount is $450.
[AGENT][NEUTRAL] OK, one moment please.
[AGENT][NEUTRAL] And that was [PII]?
[CUSTOMER][POSITIVE] Yes, that's correct.
[AGENT][NEUTRAL] Alright, thank you, [PII]. I'm not showing any claims on file for that date of service.
[CUSTOMER][NEUTRAL] Uh, may I know the mailing address for filing a claim?
[AGENT][NEUTRAL] Uh, claims mailing address would be [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] That's in [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mm, OK.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Actually we have sent CMS 1500 for this claim via mail on [PII].
[CUSTOMER][NEUTRAL] I'm not sure if.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] And the patient is active actually.
[AGENT][NEUTRAL] Yeah, the effective date is [PII]. Patient is still active.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] So I'm not sure why this claim has not been received to your end. Um, I do have another data service for the same patient is [PII] with charge amount $150.
[CUSTOMER][NEUTRAL] Are you able to pull that claim?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Yes, correct.
[AGENT][NEUTRAL] Yeah, no claims on file for that date of service.
[CUSTOMER][NEUTRAL] Uh, we have in my notes, uh, on my end it shows that CMS 1500 with primary pay EOP has been mailed.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] Yeah, I don't show anything on file. It can be resubmitted, but the last claim on file that we received was for a date of service of June.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm. June.
[AGENT][NEUTRAL] That's the last claim on file, so the dates of service that you're searching for we don't have anything. The claim would need to be resubmitted.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, um, may I know the reference number for our organization, and may I know the timely filing limit to submit this claim?
[AGENT][NEGATIVE] No timely filing.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And the call reference is going to be my name with my last initial then today's date. My name again is [PII], that's [PII] Last initial is [PII].
[CUSTOMER][POSITIVE] Alright, thank you so much, [PII], for your assistance. You have a nice one.
[AGENT][NEUTRAL] You too, [PII]. Bye-bye.
[CUSTOMER][NEUTRAL] Goodbye.