AccountId: 011433970860
ContactId: 9b46532b-11c4-475d-ac64-be6adaeae40c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 430380 ms
Total Talk Time (AGENT): 164004 ms
Total Talk Time (CUSTOMER): 205521 ms
Interruptions: 7
Overall Sentiment: AGENT=0.4, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/27/9b46532b-11c4-475d-ac64-be6adaeae40c_20250527T20:13_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] Well hello Miss. [PII], this is [PII]. How are you, dear?
[AGENT][POSITIVE] I'm great, [PII]. How are you today?
[CUSTOMER][NEUTRAL] I am fine. I am fine. Miss [PII], I, I have a provider on the phone. His name is [PII]. He is calling on policy 24.
[AGENT][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] 19445.
[AGENT][NEUTRAL] And let's say it's callback number, [PII]?
[CUSTOMER][NEUTRAL] Uh, well, I'll give you what he, what's on here. I did not verify it with him. I do apologize. It is [PII].
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] 338.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Uh, that's not gonna be his number. OK, and how can I help him today?
[CUSTOMER][NEUTRAL] Right, that's why I don't ask him that because it's never, yeah, um, he, he has, uh, checking on claim status and the date of service is [PII].
[AGENT][NEUTRAL] Did he give you a bill amount?
[CUSTOMER][NEGATIVE] It did not. I, I didn't ask for it.
[AGENT][NEUTRAL] Yeah, I'll get all that from him. So he's just needing claim status and his name is [PII]. Is that correct, [PII]? And there's.
[CUSTOMER][NEUTRAL] His name is [PII], yes.
[AGENT][NEUTRAL] And which policy did he tell you which one of these?
[CUSTOMER][NEUTRAL] But.
[CUSTOMER][NEUTRAL] I think it's [PII]. I think it was [PII], he's called. I think, I'm sorry.
[AGENT][NEUTRAL] OK, I'll be.
[AGENT][POSITIVE] Yeah. That's fine. No, I'll, I'll take care of all that. So, uh, yeah, I can help him.
[CUSTOMER][POSITIVE] OK, darling. OK, thanks. Bye.
[AGENT][POSITIVE] Thanks, [PII]. All righty. Bye.
[AGENT][NEUTRAL] Hi, [PII].
[CUSTOMER][NEUTRAL] Hey, good afternoon.
[AGENT][NEUTRAL] Hi, this is [PII]. So [PII] said that you're needing to check claim status on a member. Is that correct?
[CUSTOMER][POSITIVE] Hi, this is [PII].
[CUSTOMER][NEUTRAL] you're needing to check on.
[CUSTOMER][POSITIVE] Yes, that's correct.
[AGENT][NEUTRAL] Yes, I can help you with that. And what is your callback number, [PII]?
[CUSTOMER][NEUTRAL] Sure. [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you and what is your patients uh well first off, any information that I provide for you will be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] any information that I.
[CUSTOMER][NEUTRAL] What
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] OK. Patient's name is [PII], and the date of birth is [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And what is the data service and total bill amount that you're calling about?
[CUSTOMER][NEUTRAL] wanted to go a service and sort of building it that you're calling about.
[CUSTOMER][NEUTRAL] Um, the service is [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, total charges are $4103 and the remaining balance is $45.
[AGENT][NEUTRAL] Uh.
[AGENT][NEUTRAL] I'm sorry, what was the total bill amount? I did not understand you.
[CUSTOMER][NEUTRAL] OK, total amount is $403.
[CUSTOMER][NEUTRAL] And the remaining balance is.
[CUSTOMER][NEUTRAL] $45.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] OK, and you said that the total bill amount was 403.
[CUSTOMER][NEUTRAL] OK, and you said that the total bill amount was 4035 is that correct? Yes.
[AGENT][NEUTRAL] And a remaining of 45. Is that correct?
[AGENT][NEUTRAL] OK, so we do not have a claim on file for either one of those amounts.
[CUSTOMER][NEUTRAL] OK, so we do.
[AGENT][NEUTRAL] For this member for that data service.
[CUSTOMER][NEUTRAL] For this number connected.
[CUSTOMER][NEUTRAL] OK, you don't have any claim on file. I can see here on my system that you processed the claim.
[AGENT][NEUTRAL] That is
[AGENT][NEUTRAL] OK, then you, I think.
[CUSTOMER][NEUTRAL] And you see in the season that you.
[CUSTOMER][NEUTRAL] Go ahead, go ahead.
[AGENT][NEUTRAL] You see in what system that the claim was processed.
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] I'm sorry?
[AGENT][NEUTRAL] There's not a claim on file with APL for that billed amount.
[CUSTOMER][NEUTRAL] There's not a
[CUSTOMER][NEUTRAL] You can
[CUSTOMER][NEUTRAL] OK. Just to confirm, your billing address?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] PO Box 248,950 Oklahoma City.
[CUSTOMER][NEUTRAL] [PII]. Is that correct?
[AGENT][NEUTRAL] [PII]. Yes, that is correct.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yes, so in that case, uh, I'm going to, uh, repro uh submit the claim, OK? Maybe you can reprocess, the claim.
[AGENT][NEUTRAL] OK, and then
[AGENT][NEUTRAL] You would need to also submit, make sure to send the primary insurance company's explanation of benefits along with the claim for review.
[CUSTOMER][NEUTRAL] me
[CUSTOMER][NEGATIVE] Disappointing.
[AGENT][NEUTRAL] And then once the claim has been processed by APL dated, we do have a portal that you should be able to check claim status in and the website for our portal is located at [PII].
[CUSTOMER][NEUTRAL] And then once the claim has been canceled by AP if we do have a portal that you should be able to check the status.
[CUSTOMER][NEUTRAL] And the website for our portal is located at [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Perfect.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, just to confirm, do you have any payer ID?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And again, the prime.
[CUSTOMER][NEUTRAL] 60801.
[AGENT][NEUTRAL] Yes. And again, the primary insurance company explanation of benefits is also required with the claim.
[CUSTOMER][POSITIVE] OK, perfect.
[CUSTOMER][NEUTRAL] Well thank you for that information. Uh, can you please tell me what is the timely filing?
[AGENT][NEGATIVE] There is no timely filing limit?
[CUSTOMER][NEUTRAL] I'm sorry?
[AGENT][NEGATIVE] No timely filing limits.
[CUSTOMER][NEUTRAL] Oh, OK, got it.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Well [PII] I do appreciate your assistance. Thank you for the information. Have a great day, OK.
[AGENT][POSITIVE] Well, well, you're very, yes, I hope you have a good day too, [PII]. Is there anything else that I can help you with?
[CUSTOMER][NEUTRAL] Yes, even before I let you go, do you have any reference number for this call?
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] You would use my name along with today's date.
[CUSTOMER][POSITIVE] Perfect.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Once again thank you [PII] for your assistance. Thank you.
[AGENT][POSITIVE] Oh, you're welcome, [PII]. Yes, sir, and thank you again for calling APL.
[CUSTOMER][NEUTRAL] Bye bye.
[AGENT][NEUTRAL] Uh-huh. Bye-bye.