AccountId: 011433970860
ContactId: 9825f46c-3633-4590-9c2f-16c0ef1224be
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 280600 ms
Total Talk Time (AGENT): 115897 ms
Total Talk Time (CUSTOMER): 124054 ms
Interruptions: 4
Overall Sentiment: AGENT=0.2, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/13/9825f46c-3633-4590-9c2f-16c0ef1224be_20250313T17:24_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. This is [PII] calling from MUSCs to check on the claim status.
[AGENT][NEUTRAL] OK, you said your name is [PII]?
[CUSTOMER][POSITIVE] That's correct.
[AGENT][NEUTRAL] And you're needing claim status for one member, is that correct, [PII]?
[CUSTOMER][POSITIVE] That's right.
[AGENT][POSITIVE] Yes, I can help you with that. And what is your callback number, please?
[CUSTOMER][NEUTRAL] Callback number is [PII] direct line.
[AGENT][NEUTRAL] Thank you and the member's policy number please?
[CUSTOMER][NEUTRAL] Number 20. Member ID is.
[CUSTOMER][NEUTRAL] 02560355
[CUSTOMER][NEUTRAL] So
[AGENT][NEUTRAL] Thank you one moment while I get the member's information pulled up please.
[CUSTOMER][NEUTRAL] That like. Yeah.
[AGENT][NEUTRAL] And the information [PII] that I do provide for you today would be a verification of benefits and not a guarantee of payment. What is your patient's name please and their date of birth?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] My name is [PII] and date of birth.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] And what is the date of service and total bills amount for him please?
[CUSTOMER][NEUTRAL] So for.
[CUSTOMER][NEUTRAL] Data Services, [PII] for the bill amount of $421 even.
[AGENT][POSITIVE] Thank you, one moment.
[CUSTOMER][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] And what is the facility name?
[CUSTOMER][NEUTRAL] So let me.
[CUSTOMER][NEUTRAL] Facility name is MULC Physicians.
[AGENT][NEUTRAL] OK, we do not have a claim on file for him for data service 11-19 2024 and the amount of $421.
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] 1. Got it. Can I have the member's policy effective and termination date?
[AGENT][NEUTRAL] The effective date on this plan is [PII] and there is no termination date.
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] that.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Can I have a mailing address to resume the claim?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] What?
[AGENT][NEUTRAL] And the zip code is [PII].
[CUSTOMER][NEUTRAL] 1.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] 7.
[AGENT][NEUTRAL] And when the claim is submitted to APL for review Chan, you will also need to include a copy of the primary insurance company's explanation of benefits as well.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] It's a lot.
[CUSTOMER][NEUTRAL] Like
[CUSTOMER][NEUTRAL] Yeah well.
[CUSTOMER][NEUTRAL] Got it.
[AGENT][NEUTRAL] And then once I once we have processed the claim, we also we have a portal in which you should also be able to check our claim status and our portal website is secured. [PII].
[CUSTOMER][NEUTRAL] 2
[CUSTOMER][NEUTRAL] The
[CUSTOMER][POSITIVE] Got it. Thank you so much for the information.
[AGENT][NEUTRAL] You're welcome. Yes, sir, is there anything?
[CUSTOMER][NEUTRAL] Mm, can I have the time to submit the claim?
[AGENT][NEGATIVE] There is no timely filing limit.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Sorry?
[CUSTOMER][NEGATIVE] 0 time filing timely filing we did not have a timely filing limit. Got it. And can I have the payer ID?
[AGENT][NEGATIVE] There is 0 time filing timely filing limit. We do not have a timely filing limit.
[AGENT][NEUTRAL] 60801.
[CUSTOMER][NEUTRAL] 60801.
[CUSTOMER][NEUTRAL] Can I have the reference number for this call?
[AGENT][NEUTRAL] You would use my name that I gave you along with today's date.
[CUSTOMER][NEUTRAL] Can you repeat my name that I gave you along with today's date.
[CUSTOMER][POSITIVE] Got it. Thank you so much for your patience and assisting me, [PII]. Have a great rest of your day. Stay safe. Take care. Bye-bye.
[AGENT][POSITIVE] Well, you're certainly very welcome. Yeah, so, yeah, I hope you do too, [PII], and if that's all I can help you with, thank you again for calling ATL. Have a great afternoon.
[CUSTOMER][POSITIVE] Yeah, so if you do you can, and if that's all I can help you with thank you again for calling us. Have a great rest of your day. Bye bye.