AccountId: 011433970860
ContactId: a0b370ea-dd15-436e-9819-0e408e887460
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1603420 ms
Total Talk Time (AGENT): 276193 ms
Total Talk Time (CUSTOMER): 755762 ms
Interruptions: 8
Overall Sentiment: AGENT=-0.2, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/21/a0b370ea-dd15-436e-9819-0e408e887460_20250421T19:51_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi [PII]. My name is [PII] calling for the provider to check on a claim status. Please be informed that this call is being recorded and monitored for quality and training purposes. So may I know how can I help you with the patient's information or the provider's information?
[AGENT][NEUTRAL] I need a phone number.
[CUSTOMER][NEUTRAL] Yeah, it's [PII]. No extension it's a direct line.
[AGENT][NEUTRAL] And the policy number?
[CUSTOMER][NEUTRAL] Policy number will be 02519409.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] Patient's name.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Patient's first name is [PII] and the last name is [PII], and the date of birth will be [PII].
[AGENT][NEUTRAL] Thank you, [PII], and you are needing claim status?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, I can help you with that. What data service.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the build amount.
[CUSTOMER][NEUTRAL] So.
[CUSTOMER][NEUTRAL] $397.26.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] Hold on one moment.
[CUSTOMER][NEUTRAL] Yeah, sure.
[AGENT][NEUTRAL] OK, we did pay that claim. We paid $16.69.
[CUSTOMER][NEUTRAL] OK. When you guys received the claim?
[AGENT][NEUTRAL] Hold on just a moment, I can tell you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] We received it on [PII]. It was paid on [PII].
[CUSTOMER][NEUTRAL] OK. And when was the claim processed on the same date?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] Yeah, OK. And could you please help me with the allowed amount of the claim?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] This is a secondary policy. It doesn't have a loud amount. It coordinates with the primary.
[CUSTOMER][NEUTRAL] OK, um, I've been looking at, uh, uh, I.
[CUSTOMER][NEGATIVE] And you don't have the patient responsibility also.
[AGENT][NEUTRAL] Whatever's left over would be patient's responsibility.
[CUSTOMER][NEUTRAL] So how much I want is left uh there is nothing left.
[AGENT][NEUTRAL] Do what now?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] How much amount is left?
[AGENT][NEUTRAL] Whatever we didn't pay on the 1669 that we pay.
[CUSTOMER][NEUTRAL] what was the.
[CUSTOMER][NEUTRAL] OK, and could you please tell me, so that means for this one, you don't have the allowed amount. Am I right? You pay the whole amount.
[AGENT][NEUTRAL] Right, there's no loud amount. It just coordinates with the primary insurance.
[CUSTOMER][NEUTRAL] I'm talking about the patient's responsibility. You paid the whole amount, that means there is no patient's responsibility.
[AGENT][NEUTRAL] Right, right.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and could you please tell me?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] How was the payment then via check or IFT?
[AGENT][NEUTRAL] Paper check
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Uh, could you please send me the check number?
[AGENT][NEUTRAL] 2039036
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] The name
[CUSTOMER][NEUTRAL] Was it a single or bulk?
[AGENT][NEUTRAL] Single check, we do not issue bulk checks.
[CUSTOMER][NEUTRAL] OK, and could you please tell me uh the payment's mailing address?
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] You be.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, and could you please verify me the patient's account number as well?
[AGENT][NEUTRAL] The patients what?
[CUSTOMER][NEUTRAL] Patient's account number.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEGATIVE] I still didn't understand what you said.
[CUSTOMER][NEUTRAL] The patient's account number.
[AGENT][NEUTRAL] It's the one you gave me.
[CUSTOMER][NEUTRAL] Uh, could you please verify me the patient's account number, V as in Victor number.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] There are 2 numbers in between stands. V as in Victor comes.
[AGENT][NEUTRAL] I don't understand what you're talking about. The, the account number with us is the policy number that you gave me.
[AGENT][NEGATIVE] I don't understand what patient account number you want.
[CUSTOMER][NEUTRAL] Yeah, but the patient have the, yeah, but the patient.
[CUSTOMER][NEUTRAL] Yeah, the, the patient have a different account number as well. It considers the alphabet in between the numbers.
[CUSTOMER][NEUTRAL] Do you have any number with you?
[AGENT][NEUTRAL] No, I do not. I just have their policy number with us.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK, so could you please tell me.
[AGENT][NEUTRAL] You got
[CUSTOMER][NEUTRAL] The clean, sorry, what are you trying to tell me?
[AGENT][NEUTRAL] Go ahead.
[AGENT][NEUTRAL] Go ahead.
[CUSTOMER][NEUTRAL] OK. Could you please help me with the claim number?
[AGENT][NEUTRAL] 3589096.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK, and could you, do you have any uh payment cash clear day?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It probably hasn't cleared. It just got paid on [PII].
[CUSTOMER][NEUTRAL] That's.
[AGENT][MIXED] It's still outstanding, but it was just issued on [PII].
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] OK, so it's, it's not clear yet. Am I right?
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEGATIVE] It has not cleared.
[CUSTOMER][NEUTRAL] OK, give me a minute.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] OK, uh, give me a minute.
[CUSTOMER][NEUTRAL] Right
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. And could you please send me a copy of your?
[AGENT][NEUTRAL] What's the fax number?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][POSITIVE] OK, I'll thank.
[CUSTOMER][NEUTRAL] In attention to the patient's account number.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, I'll fax it to you.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] And how much time you will receive the copy of you be?
[AGENT][NEUTRAL] In the next hour
[CUSTOMER][NEUTRAL] OK, just a moment. OK, and what will be the call reference number for our conversation?
[AGENT][NEUTRAL] We do not have call reference numbers. You use my name in today's date.
[CUSTOMER][NEUTRAL] Do you want.
[CUSTOMER][NEUTRAL] OK. What's your name? Could you please tell me once again?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] OK, shall we move to the next claim?
[AGENT][NEUTRAL] I can help you with 3.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] And that's it, um.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Hold on one moment. It'll take me a moment.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Right
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] What's the next one?
[AGENT][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] The next member ID is
[CUSTOMER][NEUTRAL] Yeah I'm I audible?
[AGENT][NEUTRAL] Go ahead.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] The next member ID is 01835977.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] Patient's name.
[CUSTOMER][NEUTRAL] Patient's first name is [PII] and the last name is [PII]. And the date of birth will be [PII].
[AGENT][NEUTRAL] Date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Data service.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] Bill charge amount?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh yeah, it will be.
[CUSTOMER][NEUTRAL] $1,764.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Is this facility bill or?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Doctor's charge.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEGATIVE] I didn't get it.
[AGENT][NEUTRAL] What's the procedure code on this bill? Is it for a facility bill or a doctor's charge?
[CUSTOMER][NEUTRAL] OK, yeah, just a moment. Let me just check.
[CUSTOMER][NEUTRAL] Uh, yeah, the procedure code 47563 is Lapcho W.
[CUSTOMER][NEUTRAL] To and geography, it says something like that. I don't know.
[AGENT][NEUTRAL] 47563 is the procedure code.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Thank
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Hold on one moment.
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] What.
[CUSTOMER][NEUTRAL] So.
[CUSTOMER][NEUTRAL] not for the provider and uh.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, we did get that claim in, we paid.
[CUSTOMER][NEUTRAL] I'm gonna.
[AGENT][NEUTRAL] Hold on one moment.
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] For.
[AGENT][NEUTRAL] Hold on just a second.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So this week, um.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] It.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Oh man.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Hang on just a moment. I'm, I gotta look into this one.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Yeah that's my favorite.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEGATIVE] OK, it looks like this one's been voided but it hasn't been reissued, so I'll have to go back and get someone to reissue this.
[CUSTOMER][NEUTRAL] Well.
[AGENT][NEGATIVE] It was paid at one time and for some reason it was voided.
[CUSTOMER][NEUTRAL] OK, so you're going to send back the claim for the process?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK. Just a moment.
[CUSTOMER][NEUTRAL] OK, so what will be the normal claim processing time?
[AGENT][NEUTRAL] Um, at least 3 to 5 business days.
[CUSTOMER][NEUTRAL] 3 to 5 business days.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] 3 to 5 business days. OK. And could you please tell me what will be the turnaround time?
[AGENT][NEUTRAL] 3 to 5 business days.
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] That.
[CUSTOMER][NEUTRAL] And could you please help me with the received date of the claim?
[CUSTOMER][NEUTRAL] And the claim number?
[AGENT][NEUTRAL] 351-071-6
[CUSTOMER][NEUTRAL] 350.
[AGENT][NEUTRAL] Receive 9 26 24.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] 96 926 24 you guys received the claim. Am I right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] And could you please help me with the claim number once again, I didn't note it.
[AGENT][NEUTRAL] 351-071-6.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] OK. And the, the claim has been paid.
[AGENT][NEGATIVE] It was paid but it's been voided. It needs to be reissued.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK, it needs to be the issue.
[CUSTOMER][NEUTRAL] And just a moment.
[CUSTOMER][NEUTRAL] OK. Call reference number for our conversation will be your name and today's date.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Shall we move to the next claim?
[AGENT][NEUTRAL] Hold on one moment.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] It's it's.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That is.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] They
[AGENT][NEUTRAL] OK, what's the next policy number?
[CUSTOMER][NEUTRAL] Just a moment.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, the next policy ID is 60801.
[AGENT][NEUTRAL] That's not a policy number that's our um payer ID number.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] It's your pay ID number, OK.
[CUSTOMER][NEUTRAL] Just a moment.
[CUSTOMER][NEUTRAL] On the card, OK.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And and then that.
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] Well.
[CUSTOMER][NEUTRAL] Could you please check with the uh patient's name and the date of birth?
[AGENT][NEUTRAL] I can check by the name, not the date of birth.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] What's the name?
[CUSTOMER][NEUTRAL] The members first.
[CUSTOMER][NEUTRAL] The member's first name is [PII]
[AGENT][NEUTRAL] OK, and the last name?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Sorry?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII]nandez.
[CUSTOMER][NEUTRAL] Yeah, for 9 days, those for 9 days.
[CUSTOMER][NEUTRAL] Alright.
[AGENT][NEUTRAL] And what state?
[AGENT][NEUTRAL] What state do they live in?
[CUSTOMER][NEUTRAL] OK, the state which they live in. Give me a minute.
[AGENT][NEUTRAL] There's a whole bunch of them, so you would have to give me something else.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] My social security number, policy number?
[CUSTOMER][NEUTRAL] Yeah, just
[CUSTOMER][NEUTRAL] Mm, no, the security number though they didn't have, they live in.
[CUSTOMER][NEUTRAL] OK, just a moment. Give me a minute.
[CUSTOMER][NEUTRAL] They live in [PII].
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And the city is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] Uh you get
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][POSITIVE] I like.
[AGENT][NEUTRAL] OK, there's a whole lot of them that live in [PII] as well.
[AGENT][NEUTRAL] I would have to have the policy number or their, their social security number.
[CUSTOMER][NEUTRAL] Should I provide
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] I don't have the Social Security number and the policy number that I gave you, you said it's incorrect. So I do have only the date of birth of the member.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] I can't look it up by date of birth.
[CUSTOMER][NEUTRAL] Yeah, it's uh date of birth is [PII].
[AGENT][NEUTRAL] I, I said I can't look it up by date of birth. I have to have a policy number, social, and there's a whole lot of those names in our system.
[CUSTOMER][NEUTRAL] Well
[CUSTOMER][NEUTRAL] Then should I give you the whole address of the member?
[AGENT][NEUTRAL] Yes, I can try to look by the whole address if it's correct in our system.
[CUSTOMER][NEUTRAL] OK, then I should I stay with you right now?
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Are you ready for the address?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK. It says [PII] The city is [PII], the state is [PII], and the zip code is [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, what's that number that number again at the first beginning?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] Now, what was the date of birth you say it was?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Hold on one moment.