AccountId: 011433970860
ContactId: a2ed248f-a176-49c5-93df-8803bf2f3e29
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 339380 ms
Total Talk Time (AGENT): 99880 ms
Total Talk Time (CUSTOMER): 170136 ms
Interruptions: 0
Overall Sentiment: AGENT=2, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/27/a2ed248f-a176-49c5-93df-8803bf2f3e29_20250327T13:36_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. This is [PII] calling from the provider's office to check on claim status.
[AGENT][POSITIVE] [PII], it would be a pleasure to assist you with claim status. What is the callback number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, [PII]. And the policy number for the patient, please.
[CUSTOMER][NEUTRAL] 603-996.
[AGENT][NEUTRAL] Thank you, [PII] and the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Patient is [PII] with the date of birth of [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][POSITIVE] And it would be my pleasure to help you with claim status. Do you have the claim number or date of service?
[CUSTOMER][NEUTRAL] Uh, I'm having the detail service which is for [PII]. Uh, this is for total submitted charge for $258 even.
[AGENT][NEUTRAL] I apologize. Bear with me just one second.
[AGENT][NEUTRAL] And you said [PII]? I mean, [PII].
[CUSTOMER][NEUTRAL] Mm sure.
[CUSTOMER][NEUTRAL] 1414.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, I am checking our system for claim for [PII], and I don't have a claim on file for that data service.
[CUSTOMER][NEUTRAL] Uh-huh. So, I'm confirming that, uh, actually, I'm having one more claim for the same patient, but which is the same data service different charge amount only. So for the [PII], there is no claim at all, right, for any billed amount?
[AGENT][NEUTRAL] That is correct. Now, that claim can be faxed directly to our claims department.
[CUSTOMER][NEUTRAL] Uh-huh. OK.
[CUSTOMER][NEUTRAL] Mhm. Sure, we'll do that. So, before that, I just need to be verify a few of information to double-check whether we're having all correct information or not for the patient. So, uh, let me start with the patient information here. So, uh, I'm seeing that for the plan, our patient is a subscriber, right? This is a self-coverage?
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] OK. Uh, one second, let me document it. And is it the member ID which you have provided that would be correct?
[AGENT][POSITIVE] It is correct.
[CUSTOMER][NEUTRAL] OK, one moment and let me document the same.
[CUSTOMER][NEUTRAL] And could you please check that whether the uh mailing address that we are having to submit a claim is [PII]?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] Do you have any uh payer ID?
[AGENT][NEUTRAL] 60801
[CUSTOMER][NEUTRAL] OK. One second, let me document. 608.
[AGENT][NEUTRAL] 01.
[CUSTOMER][NEUTRAL] 01. OK. Got that. And is it the group number is L Lima 0225?
[AGENT][NEUTRAL] Let me check that for you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] L Lima A Alpha 0225
[CUSTOMER][NEUTRAL] OK. Got it. And what about the effective date for the patient?
[AGENT][NEUTRAL] Effective date is
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And still active, right?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] Uh-huh. So what about the timely filing limit?
[AGENT][NEGATIVE] No timely filing.
[CUSTOMER][NEUTRAL] Uh-huh, OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And could you please check that, uh, I can provide the patient address. So could you please check, uh, is that correct on, as per your records?
[AGENT][NEUTRAL] OK. What is that address?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] Yes, that is what we have on file.
[CUSTOMER][NEUTRAL] Uh-huh. And could you please also check whether the provider has been in network?
[AGENT][NEUTRAL] The policy participates in the Carrington.
[CUSTOMER][NEUTRAL] Uh-huh. OK.
[AGENT][NEUTRAL] Network
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, so, I'm also confirming as it has been no claim found at your end, you are not seeing any kind of rejections for this patient, right?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][POSITIVE] Uh-huh. Thank you so much for all this confirmation, [PII]. So, uh, can I also get a call on this patient call?
[AGENT][NEUTRAL] Call reference number is my name and today's date, and I spell my name [PII]
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] First initial and my last name is [PII].
[CUSTOMER][POSITIVE] Uh-huh. Got it. Thank you so much, [PII]. So, that's for today. So you can reach us at [PII] between [PII] Eastern time for any further queries. So, thanks again. Have a great day. Take care. Bye-bye.
[AGENT][POSITIVE] [PII], it was my pleasure to assist you with that claim status. Is there anything else I can help you with?
[CUSTOMER][POSITIVE] Uh, no, no. That's for today. Thank you so much.
[AGENT][POSITIVE] Thank you, [PII], for calling APL. Have a wonderful day.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] You too. Take care. Bye-bye.
[AGENT][NEUTRAL] Bye-bye.