AccountId: 011433970860
ContactId: 9fa16c60-8bc1-4b33-ad3e-f478c384e42f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 272529 ms
Total Talk Time (AGENT): 141428 ms
Total Talk Time (CUSTOMER): 89080 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=1.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/10/9fa16c60-8bc1-4b33-ad3e-f478c384e42f_20250610T18:41_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Uh, yes, so I have some old claims here, um, that a patient is looking for a refund, that's number one. I just wanna know what your timely filing in for is for claims being sent to you at secondary.
[AGENT][NEUTRAL] OK, I can, I can check and see. It really depends on the policy. Um, may I have your name?
[CUSTOMER][NEUTRAL] It's [PII]
[CUSTOMER][NEUTRAL] And are you spelling your name [PII] or is it spelled different?
[AGENT][NEUTRAL] [PII], yes, that is correct, yes. Last initial is [PII]
[CUSTOMER][POSITIVE] OK, good, good. Uh thank you.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome. May I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Sure, [PII].
[AGENT][NEUTRAL] Alright thank you and what's the name of the facility you're calling from for my notes?
[CUSTOMER][NEUTRAL] Pediatric Associates.
[AGENT][NEUTRAL] And OK. OK. Thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] It is 02443500 ML8.
[AGENT][NEUTRAL] OK, what's the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] [PII] or [PII]?
[CUSTOMER][NEUTRAL] Um, date of birth is [PII].
[AGENT][NEUTRAL] OK. Thank you. All right. So, yes, um the policy effective date is [PII]. So yes, um for this one, this is a secondary supplemental plan to the major medical and there is no timely filing limits on this one.
[CUSTOMER][NEUTRAL] Oh, it's no timely filing then? Oh.
[AGENT][NEUTRAL] Yeah. Mm.
[CUSTOMER][NEUTRAL] No timely filing lien and you said that this this um claim um policy was effective [PII]. You don't have anything for 21.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mm, let me see if there's another one on [PII]. This one was effective [PII]. Let me check the history. One moment.
[CUSTOMER][NEUTRAL] Yeah, because she's going back all the way to 21 wanting wanting her copays.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Oh, OK. Uh, yes, um, the previous one was from [PII]. And let me check and see really quick.
[CUSTOMER][NEUTRAL] Uh.
[AGENT][NEUTRAL] OK, so [PII] is also listed.
[AGENT][NEUTRAL] And you said it was for co-payments?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mm, OK.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, I'm waiting on the documents one moment.
[CUSTOMER][POSITIVE] Oh, no, no problem.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK, so this one, OK, so this particular policy, the, the old one, which is on [PII], um, this one doesn't cover the co-payment for the office visit. It will only cover if there was any procedures done in the office like injections, X-rays, sonogram, ultrasound, anything like that. So any procedures done in the office is covered, but if it's just the regular co-payment, we do not cover the regular co-payment for the visit.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Not copay. OK, that's what I need, not copays, just injections, X-rays, any office visit, procedure in office.
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Any offer procedure. Yes, any office procedure. Not, not including the copayment for the visit, correct. Mhm.
[CUSTOMER][NEUTRAL] Procedure.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] OK, that's perfect. um, so do you give um reference numbers or just your name and today's date?
[AGENT][NEUTRAL] My name in today's date.
[CUSTOMER][POSITIVE] OK, thank you. uh you really helped me out. I appreciate it.
[AGENT][NEUTRAL] Mm.
[AGENT][POSITIVE] You're welcome. Is there anything else I may help you with today?
[CUSTOMER][POSITIVE] Uh, no, that's it. Thank you so much. You have a good day.
[AGENT][POSITIVE] Welcome. You as well thank you for calling ATL. Bye-bye, Miss [PII] OK. Bye-bye.
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][POSITIVE] Alrighty bye bye.