AccountId: 011433970860
ContactId: a0478450-ed28-4762-8aaf-0910039146b4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 307140 ms
Total Talk Time (AGENT): 104663 ms
Total Talk Time (CUSTOMER): 116385 ms
Interruptions: 0
Overall Sentiment: AGENT=0, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/22/a0478450-ed28-4762-8aaf-0910039146b4_20250122T14:47_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Um, hello, um, good morning. Um, this is [PII] from provider's office and inquiring about the claim status. Um, could you assist me?
[AGENT][NEUTRAL] I can help you. What's your name?
[CUSTOMER][NEUTRAL] Um [PII].
[AGENT][NEUTRAL] [PII], OK.
[AGENT][NEUTRAL] And the first initial of your last name is [PII]?
[CUSTOMER][NEUTRAL] And then, um
[CUSTOMER][NEUTRAL] [PII], the um the, yeah.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And what's your, what's the policy number?
[CUSTOMER][NEUTRAL] And before that, can I get your first name and initial to your last name please?
[AGENT][NEUTRAL] It's [PII], first initial, the last is [PII]
[CUSTOMER][POSITIVE] OK, thank you so much.
[AGENT][NEUTRAL] The policy number?
[CUSTOMER][NEUTRAL] One moment for the um the policy number here for checking starts with 129.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 052.
[CUSTOMER][NEUTRAL] 5, M as in Mary, L as in Lima, number 7.
[AGENT][NEUTRAL] OK, and um what's a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] Um, it's [PII].
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII]. OK.
[CUSTOMER][POSITIVE] [PII]. Yes, correct.
[AGENT][NEUTRAL] Thank you. And the patient's name and date of birth?
[CUSTOMER][NEUTRAL] A patient name is [PII].
[CUSTOMER][NEUTRAL] Date of birth is [PII] of
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you. And you said that you're checking for a claim status?
[CUSTOMER][POSITIVE] Yes, for this one.
[AGENT][NEUTRAL] OK, we can help you with that. What's the date of service in charge?
[CUSTOMER][NEUTRAL] Um, date of service here is um [PII], um, the amount of $602.
[AGENT][NEUTRAL] You can also check your status on our online service center at [PII]. If you have further claim statuses, one moment.
[AGENT][NEUTRAL] I'm not showing [PII] um on file for the patient.
[CUSTOMER][NEUTRAL] OK, one moment, please.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Um, so I'm meaning to say, um, [PII], that, um, there was no claim on file under the date of service, am I right?
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] We've not received a claim for that date of service.
[AGENT][NEUTRAL] And also need to give you the current policy number. Let me know when you're ready for that.
[CUSTOMER][POSITIVE] Yes, I'm ready.
[AGENT][NEUTRAL] That number is 185-0627.
[AGENT][NEUTRAL] And did you have any other questions?
[CUSTOMER][NEUTRAL] Uh, one moment please, just to make sure.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Policy number. So I mean to say, um [PII], the current policy number starts with 1850627. Am I right?
[AGENT][NEUTRAL] That's the current policy number for the date of service that you provided. That is correct. The one you gave me is no longer active.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] Yeah, yeah, and I just want to ask um [PII] about the eligibility of this member, please.
[AGENT][NEUTRAL] Mhm. Effective date is [PII]. This policy is active at this time.
[CUSTOMER][NEUTRAL] So with no termination date, am I correct for this one?
[AGENT][NEUTRAL] The policy is currently active at this time.
[CUSTOMER][POSITIVE] OK, thank you so much and then um.
[CUSTOMER][NEUTRAL] Um, can I get the claim um claim mailing address for this one, please?
[AGENT][NEUTRAL] It's PO Box.
[AGENT][NEUTRAL] 248
[AGENT][NEUTRAL] 950.
[AGENT][NEUTRAL] Oklahoma City, [PII].
[AGENT][NEUTRAL] And the zip code is [PII].
[CUSTOMER][NEUTRAL] And then I'm gonna get the um click um what do you call this one the payer ID as well please.
[AGENT][NEUTRAL] 60801.
[CUSTOMER][NEUTRAL] 660801. OK.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] And then I just want to ask the timely fi limit for um claim submission.
[AGENT][NEGATIVE] No timely filing.
[CUSTOMER][POSITIVE] OK, thank you so much and then um.
[CUSTOMER][NEUTRAL] Um, can I get the call reference number for my documentation?
[AGENT][NEUTRAL] My name is today's date. my name in today's date.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, one moment.
[CUSTOMER][POSITIVE] All right, I think that's all for me um [PII], and thank you so much for assisting this today. Thank you.
[AGENT][POSITIVE] You're welcome. Thanks for calling APL Princes. Have a good day as well.
[CUSTOMER][POSITIVE] Bye for now. Thank you.