AccountId: 011433970860
ContactId: a253d92e-0386-4976-9faa-36dc16e68eaa
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 296750 ms
Total Talk Time (AGENT): 81542 ms
Total Talk Time (CUSTOMER): 132214 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/05/a253d92e-0386-4976-9faa-36dc16e68eaa_20250305T19:05_UTC.wav
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[AGENT][NEUTRAL] For calling ATL, this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yeah, hi, my name is [PII] calling from Optum Medical KPC. Could you please help me with the claims of the member?
[AGENT][NEUTRAL] Help you with
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] How can I help you?
[CUSTOMER][NEUTRAL] Can you please help me with the claim status of the member?
[AGENT][NEUTRAL] A claim status. OK, I can assist you with the claim status, [PII]. What's the policy number?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yeah, the policy number is 01939623 M as in Mary, L as in Lima 8.
[AGENT][NEUTRAL] A good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] It's [PII]. There is no extension, it's a direct line.
[AGENT][NEUTRAL] Repeat your phone number for me please?
[CUSTOMER][NEUTRAL] Yeah, sure. [PII]. There is no extension, it's a direct line.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And what is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yeah, [PII]'s uh last name is [PII] and first name is [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] Thank you and you said you're checking claim status, provide the date of service and the charge please.
[CUSTOMER][NEUTRAL] Yeah. The date of service is [PII] and the total charge amount is $1,716.
[AGENT][NEUTRAL] $1,116?
[CUSTOMER][NEUTRAL] $1,716.
[AGENT][NEUTRAL] Mhm. And you said the year is [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Well, I'm looking for the claim, um, [PII], you can also search for claim status online at [PII].
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And I do not show data service [PII] on file.
[CUSTOMER][NEUTRAL] OK. Uh actually, we build the claim on um
[CUSTOMER][NEUTRAL] [PII] to the address of
[CUSTOMER][NEUTRAL] Oh, my system is slowly, uh, yeah, for the address of Miss American Public Life Insurance, so [PII].
[CUSTOMER][NEUTRAL] OK. L A H O M A C. OK. 73124.
[AGENT][MIXED] That is correct, but I don't show that we've received it.
[CUSTOMER][NEUTRAL] But we are submitted.
[CUSTOMER][NEUTRAL] Clean and.
[CUSTOMER][NEUTRAL] Yes, sir. The address was correct and we submitted this claim through paper.
[AGENT][NEGATIVE] We've not received it, [PII].
[CUSTOMER][NEUTRAL] OK. Can I bill this claim again with the same address?
[AGENT][POSITIVE] The address is correct.
[CUSTOMER][NEUTRAL] OK. Can I bill this claim with the paper or electronic?
[AGENT][NEUTRAL] It's your choice.
[CUSTOMER][NEUTRAL] OK. Can you provide me the payer ID and the TFL?
[AGENT][NEUTRAL] The payer ID and.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] You said can I provide the payer ID and what else?
[CUSTOMER][NEUTRAL] I just want to know the payer ID and the timely filing limit.
[AGENT][NEUTRAL] OK, the payer ID number is 60801.
[AGENT][NEGATIVE] No timely filing limit.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK. Thank you so much. So uh can you also provide me the effective dates of the member?
[AGENT][NEUTRAL] One moment
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Yeah, sure.
[AGENT][NEUTRAL] The policy effective date is [PII]. Policy is active at this time.
[CUSTOMER][NEUTRAL] [PII], right?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] OK. Can you please help, yeah, can you please help me with your name and the call reference number?
[AGENT][NEUTRAL] You'll use my name in today's date as your reference, [PII] last name is [PII]. And did you have any other questions?
[CUSTOMER][POSITIVE] No, thank you, [PII], for giving me this information. Have a great day and bye for now.
[AGENT][POSITIVE] You're welcome. Thanks for calling APL. Have a good day.