AccountId: 011433970860
ContactId: 9dbcbee9-4b41-4dd3-801e-998e69113426
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 354910 ms
Total Talk Time (AGENT): 145476 ms
Total Talk Time (CUSTOMER): 96492 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/25/9dbcbee9-4b41-4dd3-801e-998e69113426_20250325T20:13_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, I'm calling to check liens so.
[AGENT][POSITIVE] OK, I'll be more than happy to help you with the claims. May I have your name?
[CUSTOMER][NEUTRAL] Um, yeah, my name is [PII], initial of my last name, it is [PII]. Sorry, what is your name again?
[AGENT][NEUTRAL] My name is [PII].
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] You're welcome, and [PII]. May I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII] it is a direct line?
[AGENT][POSITIVE] Thank you for that. And how many clients do you have in total today?
[CUSTOMER][NEUTRAL] One
[AGENT][NEUTRAL] All right. May I have the member's policy number?
[CUSTOMER][NEUTRAL] Um, it is 1442401.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] It is [PII], [PII].
[AGENT][POSITIVE] Thank you. So that
[AGENT][NEUTRAL] 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 you want me to check on?
[CUSTOMER][NEUTRAL] I'm sorry, what's that again?
[AGENT][NEUTRAL] May I have the date of service for the claim you'd like me to check on?
[CUSTOMER][NEUTRAL] Uh-huh, it is for [PII]. The bill amount is $216 so.
[AGENT][NEUTRAL] Thank you, hold on one moment and just for the call again all the information provided is a verification of benefits, not a guarantee of payment. Hold on one moment while I locate that claim for you, OK?
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] And what is the name of the provider's office on the claim?
[CUSTOMER][NEUTRAL] Prisma.
[AGENT][NEUTRAL] Prisma, OK, hold on one moment.
[AGENT][NEUTRAL] So we received two claims for this data service, both from Prisma, but neither are with the total bill of $216. Um, what is your tax ID?
[CUSTOMER][NEUTRAL] Um, the tax ID is [PII].
[AGENT][NEUTRAL] I think this is the same. Hold on one moment.
[AGENT][NEUTRAL] OK, so this one is a different text. Hold on one moment.
[AGENT][NEUTRAL] OK, so the claim that came in with the same tax ID has a total bill of $30. Would this be the same claim or if not, your claim is not on file?
[CUSTOMER][NEUTRAL] Um, actually it's different. I would like to verify for the um CPT code. Is it for I'm calling for the code 99203 and 81003.
[CUSTOMER][NEUTRAL] Is that the one that you have?
[AGENT][NEUTRAL] Yeah, no, there's a different claim.
[AGENT][NEUTRAL] So your claim is not on file. There's no, go ahead.
[CUSTOMER][NEUTRAL] OK. So you don't have
[CUSTOMER][NEUTRAL] Oh yeah, um, I would like to verify, so you don't have the claim on file, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Alright, and what is your timely filing for claim submission?
[AGENT][NEUTRAL] Um, there's no timely filing as long as the policy was active on the date of service and this policy did not term until [PII], so you can still file the claim if you like.
[CUSTOMER][NEUTRAL] Um, could you verify if the number is active during date of service?
[AGENT][NEUTRAL] Yes, as I just stated, the policy did not lapse until [PII]. So on your date of service as [PII], the policy was active, so you can file the claim if you like.
[CUSTOMER][NEUTRAL] Alright, um, where can you send the claim?
[AGENT][NEUTRAL] So you can fax it, you can, um,
[AGENT][NEUTRAL] Mail it or you can send it electronically. Um, which one would you prefer?
[CUSTOMER][NEUTRAL] Um, actually we normally send our claim electronically.
[AGENT][NEUTRAL] OK, our payer ID is 60801.
[CUSTOMER][NEUTRAL] 60801, right?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] Sorry, this is your?
[AGENT][NEUTRAL] This is APL payer ID for electronic payments and claims.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you and if you will be sending it through mail, we can send it to [PII].
[CUSTOMER][NEUTRAL] Right?
[AGENT][NEUTRAL] No, um, our claims, no, our claims mailing address is [PII].
[CUSTOMER][NEUTRAL] Is that right?
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Zip code is [PII].
[CUSTOMER][POSITIVE] All right, thank you, [PII] for this information. We're just gonna send the claim. Thank you.
[AGENT][POSITIVE] You're welcome. Was there anything else I can assist you with today?
[CUSTOMER][POSITIVE] Um, no, thank you. Have a great day. Bye bye.
[AGENT][POSITIVE] You're welcome. Thanks for calling APL. Bye bye.