AccountId: 011433970860
ContactId: a71e4a83-f4bd-4252-9e03-80909d89101d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 252119 ms
Total Talk Time (AGENT): 100759 ms
Total Talk Time (CUSTOMER): 82900 ms
Interruptions: 1
Overall Sentiment: AGENT=0, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/28/a71e4a83-f4bd-4252-9e03-80909d89101d_20250328T17:41_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, I'm [PII] calling from provider's office to check in claim status.
[AGENT][NEUTRAL] Sure, I can check on a point for you. Uh, [PII], can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure. It's [PII].
[AGENT][NEUTRAL] Thank you. And then do you have the policy number?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Member ID is going to be 025.
[CUSTOMER][NEUTRAL] 89486.
[AGENT][NEUTRAL] OK, and what was the name and date of birth for the member, please?
[CUSTOMER][NEUTRAL] Yes, member's name is [PII]. Date of birth will be [PII].
[AGENT][NEUTRAL] OK, thank you for verifying that and what was the date of service for this claim?
[CUSTOMER][NEUTRAL] Actually, I have two data service uh for the same patient. The first one is [PII] with the charge amount of $160 even.
[AGENT][NEUTRAL] 160. OK, thank you. One moment.
[AGENT][NEUTRAL] OK, so for this member, uh, I'm not actually showing that we've received any claims yet for this number.
[CUSTOMER][NEGATIVE] Actually, uh, in my hand, it shows the claim, uh, got rejected.
[AGENT][NEUTRAL] Do you have a claim number?
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] I'm not showing that we've received any claims for this member yet. The effective date was [PII] or excuse me, [PII], and we've not yet received any claims.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] In my hand, it shows uh a failed failed rejection as a secondary claims cannot be processed for this payer.
[AGENT][NEGATIVE] Um, I don't see that we received that. I would have it resent to us, [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Could you please help me to check the eligibility for this patient?
[AGENT][NEUTRAL] Yes, it is currently active. Um, yes, it is currently active, but the effective date was [PII].
[CUSTOMER][NEUTRAL] The summit and first.
[CUSTOMER][POSITIVE] Thank you so much.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And uh
[CUSTOMER][NEUTRAL] May I know the payer ID and claiming mailing address?
[AGENT][NEUTRAL] Yes, and I've also got a fax number too if you'd like. Um, our payer ID is 60801.
[CUSTOMER][POSITIVE] Thank you so much. And the claim mailing address?
[AGENT][NEUTRAL] Uh-huh, and then the mailing address? Yes, that is [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And that is in [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][POSITIVE] Got it. Thank you so much. And I do have one more data of service for the same patient. Could you please help me with that?
[AGENT][NEUTRAL] Again, for this member I don't have any claims on file.
[AGENT][NEUTRAL] I'm not showing that we've received any for this number.
[CUSTOMER][NEUTRAL] Got it.
[CUSTOMER][POSITIVE] Thank you so much. And could you please spell out your name for me?
[AGENT][NEUTRAL] Sure, it's [PII]
[AGENT][NEUTRAL] Was there anything else I can help you with, [PII]?
[CUSTOMER][POSITIVE] Thank you. And the call.
[CUSTOMER][NEUTRAL] That's all for today. Can you provide me the call reference number?
[AGENT][NEUTRAL] I'm sorry.
[AGENT][NEUTRAL] Yes, reference number would just be my first name, last initial, and today's date, uh, so my last initial is A.
[CUSTOMER][POSITIVE] Thank you so much.
[AGENT][POSITIVE] Of course, thanks for calling APL. I hope you have a great rest of your day.