AccountId: 011433970860
ContactId: a61d0ef5-9b79-4ad8-8157-d82083576aea
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 436869 ms
Total Talk Time (AGENT): 118240 ms
Total Talk Time (CUSTOMER): 166398 ms
Interruptions: 1
Overall Sentiment: AGENT=0.9, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/04/a61d0ef5-9b79-4ad8-8157-d82083576aea_20250304T19:17_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Hello, it's [PII] calling from the provider's office. I need your help regarding a claim status. Can you help me?
[AGENT][NEUTRAL] Uh, check on claim status you said?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] OK, yeah, I can help you with that. [PII], can I get a good callback number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure, the callback number is [PII].
[AGENT][NEUTRAL] OK, thank you. And do you have the policy number?
[CUSTOMER][NEUTRAL] The policy number is 2502532.
[AGENT][NEUTRAL] OK and then what was the name and date of birth for the insured please?
[CUSTOMER][NEUTRAL] Provider
[CUSTOMER][NEUTRAL] Name is [PII].
[CUSTOMER][NEUTRAL] And date of birth for this member is just a second.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you for verifying that [PII] and what was the date of service for this client, please?
[CUSTOMER][NEUTRAL] Data service is [PII]. Bill amount $582 even.
[AGENT][POSITIVE] OK, got it, thank you one moment please.
[AGENT][NEUTRAL] [PII], what was the name of the uh provider's office this was with?
[CUSTOMER][NEUTRAL] It's inpatient Healthcare Group PL.
[AGENT][NEUTRAL] Do you have that tax ID by chance?
[CUSTOMER][NEUTRAL] Yeah, I have the tax ID that's [PII].
[AGENT][NEUTRAL] OK, one moment, please.
[AGENT][NEUTRAL] This amount, [PII], the $582 is that the amount before or after, uh, major medical paid?
[CUSTOMER][NEGATIVE] That's the original bill amount for the claim and uh the primary payer paid, uh didn't pay anything.
[AGENT][NEUTRAL] The primary did not pay anything?
[CUSTOMER][NEUTRAL] Uh, the
[CUSTOMER][NEUTRAL] Yeah, I just applied the uh the allowed amount as the patient responsibility as deductible.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 55
[AGENT][NEUTRAL] So I am not showing that we have received this claim, [PII], but we do have to have that primary EOB um for claims, but this is a secondary medical policy.
[CUSTOMER][NEUTRAL] 553 5.
[CUSTOMER][NEUTRAL] medical
[AGENT][NEUTRAL] But I don't see that we've received this claim at all for this number.
[CUSTOMER][NEUTRAL] 2
[CUSTOMER][NEUTRAL] But you have received the uh EOB.
[AGENT][NEUTRAL] No, I'm not showing that we've received this claim.
[CUSTOMER][NEUTRAL] OK, so.
[CUSTOMER][NEUTRAL] And uh the member ID and the data service and the all the information that I gave you, is this correct?
[CUSTOMER][NEUTRAL] And is the member active with the same information?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes, so the effective date was uh [PII] and it is currently active.
[CUSTOMER][NEUTRAL] January
[CUSTOMER][NEUTRAL] Sorry, what's the
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Uh yes, that was the effective date.
[CUSTOMER][NEUTRAL] The
[CUSTOMER][NEUTRAL] OK. And uh the policy number is 2502532.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Member's first name is [PII], spelled as [PII].
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] 2
[CUSTOMER][NEUTRAL] And last name is [PII], spelled as [PII].
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] And date of birth is [PII].
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, so there is no claim on file and what's the electronic payer ID or and the mailing address where we can submit claims?
[AGENT][NEUTRAL] Yes, payer ID is 60801.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] 60801.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] And the mailing address?
[AGENT][NEUTRAL] That is [PII].
[AGENT][NEUTRAL] And that is in [PII].
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] [PII], [PII].
[CUSTOMER][NEUTRAL] OK. Can you please spell it?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] A city
[AGENT][NEUTRAL] Yes, [PII] and then the state is [PII], so it's OK.
[CUSTOMER][NEUTRAL] OK, and what's the zip code?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] So I got here the
[CUSTOMER][NEUTRAL] Address is [PII]. Is this correct?
[AGENT][POSITIVE] Correct, yes.
[CUSTOMER][NEUTRAL] OK, and what's the time the filing limit?
[AGENT][NEGATIVE] There is no timely filing limit.
[CUSTOMER][NEUTRAL] OK, no timely filing limit and uh.
[CUSTOMER][NEUTRAL] What's the reference number for alcohol?
[AGENT][NEUTRAL] It would just be my first name, last initial, and today's date. Uh so my name is spelled [PII] Was there anything else I could help you with, [PII]?
[CUSTOMER][NEUTRAL] Is it [PII]?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] [PII] Alfa Romeo Alfa last name [PII].
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] Right.
[CUSTOMER][POSITIVE] OK, thank you so much, [PII], for your help today. Have a nice day, bye for now.
[AGENT][POSITIVE] Of course, thanks for calling APL you too bye bye.