AccountId: 011433970860
ContactId: a937c6a0-13ec-42e7-aa72-b4cc68123db3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 537799 ms
Total Talk Time (AGENT): 176319 ms
Total Talk Time (CUSTOMER): 201659 ms
Interruptions: 2
Overall Sentiment: AGENT=0.7, CUSTOMER=-0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/28/a937c6a0-13ec-42e7-aa72-b4cc68123db3_20250328T19:58_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yeah, hi, this [PII] calling from products office check on a claim status.
[AGENT][NEUTRAL] OK, I can help you with claim status and what did you say your name was again please one more time?
[CUSTOMER][NEUTRAL] And, and, and.
[AGENT][POSITIVE] [PII], thank you, [PII].
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And then um what is your callback number just in case the call gets disconnected?
[CUSTOMER][NEUTRAL] want
[CUSTOMER][NEUTRAL] [PII] with the [PII] of [PII].
[AGENT][NEUTRAL] Thank you. And then what's the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] No
[CUSTOMER][NEUTRAL] Yeah. The patient name is going to be?
[CUSTOMER][NEUTRAL] [PII] The last name is [PII]
[CUSTOMER][NEUTRAL] The member ID is 1445055 M as in Mike, L as in Lima 5. The date of birth is [PII].
[AGENT][NEUTRAL] OK, let me repeat the uh policy number.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] 01445055 ML 5.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] No. 1445055 ML 5.
[AGENT][POSITIVE] OK, thank you so much. Let me pull that policy up.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] This.
[AGENT][NEUTRAL] OK, what is the data service and the charge amount?
[CUSTOMER][NEUTRAL] It's going to be 1, it's going to be 124 of 2025 with the bill amount of $27 even.
[AGENT][NEUTRAL] OK, and what was the charges after the primary insurance paid their part?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] I don't know about that.
[CUSTOMER][NEUTRAL] It's 10.06.
[AGENT][NEUTRAL] OK, and can you please give me the facility name you're calling from?
[CUSTOMER][NEUTRAL] Do you do you.
[CUSTOMER][NEUTRAL] University of Miami Medicine.
[AGENT][NEUTRAL] OK, I'm gonna put you on a brief hold, Miss [PII] while I look up this claim for us and I'll be right back.
[CUSTOMER][NEUTRAL] Yeah, OK. You are on hold.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK Miss [PII], so looking on data service of [PII], I do not find a claim on file for the amount that you've given.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] Um, there is no claim as, uh, 22. OK. May I know the pay I you to submit the claim?
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] Yes, it's 60801.
[CUSTOMER][NEUTRAL] Just a minute, just a minute.
[CUSTOMER][NEUTRAL] Just a minute.
[CUSTOMER][NEUTRAL] You said there is no claim, right?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK, just a minute. I'm taking up the notes.
[AGENT][POSITIVE] OK, go ahead and take your time.
[CUSTOMER][NEUTRAL] OK. May I know the payer ID?
[CUSTOMER][NEUTRAL] Yeah, pay ID?
[AGENT][NEUTRAL] Yes, yes, it's 60801.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] And may I know the mailing address to submit the claim?
[AGENT][NEUTRAL] Yes, it's [PII].
[CUSTOMER][NEUTRAL] No
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Can you spell it? Can you spell it for me?
[AGENT][NEUTRAL] OK, [PII]
[CUSTOMER][NEUTRAL] Mm OK.
[AGENT][NEUTRAL] [PII] and then the state is also [PII].
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] OK, [PII] Uh yeah.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] And then the zip code is [PII].
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] OK, I got that sent you incorrect. OK, just a minute.
[CUSTOMER][NEUTRAL] I corrected out.
[CUSTOMER][NEUTRAL] Hm. [PII]. The ZIP code you said is
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] [PII]. Yeah, I got it. The address, the correct address. OK. May I know the effective date and the term date of this number?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] The effective date is
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the termination date is [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] The member is not active on doors?
[AGENT][NEUTRAL] Let me see if there's anything active.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] There is an active policy. Let me check that one. Let me give you that policy number.
[AGENT][NEUTRAL] 258
[CUSTOMER][NEUTRAL] Yeah, I need that.
[AGENT][NEUTRAL] Yes, 258.
[CUSTOMER][NEUTRAL] The correct ID?
[AGENT][NEUTRAL] Yes, um, that's what I'm trying to give you 258-530-6.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah. Mhm.
[CUSTOMER][NEUTRAL] It's the correct member ID, right?
[AGENT][NEUTRAL] And then I'm gonna put you on hold. I'm gonna put you on hold. I'm gonna see if there is a claim well I can see already there's no claim on that number either, so that's the correct policy number and the effective date.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah, as for checking, the claim was sent to incorrect mailing address. I checked that.
[AGENT][NEUTRAL] Right, but it wasn't sent to the right policy number.
[CUSTOMER][NEGATIVE] It was incorrect.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So it'll need to be resubmitted to the correct policy number?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, OK.
[AGENT][NEUTRAL] And that
[AGENT][NEUTRAL] Effective date is [PII].
[AGENT][NEUTRAL] And the policy is still active.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and thank you for that information. And may I know the timely filing to submit the claim?
[AGENT][NEUTRAL] There isn't one.
[CUSTOMER][NEUTRAL] Sorry? One year?
[AGENT][NEUTRAL] There isn't one.
[CUSTOMER][NEUTRAL] Sorry, I need a timely filing limit to submit the claim.
[AGENT][NEUTRAL] There isn't one.
[CUSTOMER][NEUTRAL] one
[CUSTOMER][NEUTRAL] Um, it's 90 days. I ask him for that.
[AGENT][NEGATIVE] No, there is not one no timely.
[CUSTOMER][NEGATIVE] Oh, OK, fine. There is no timely filing.
[CUSTOMER][NEUTRAL] OK. Thank you for that information. And uh can you spell out your name for documentation purpose?
[AGENT][NEUTRAL] Yes, ma'am. It's [PII]
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] OK, right, and the claim is in the mailing address you want to be submit the resubmit the claim, right?
[AGENT][NEUTRAL] Yes, you'll need to resubmit.
[CUSTOMER][NEUTRAL] And may I know the reference for this call, call reference?
[AGENT][NEUTRAL] You can use my name and today's date.
[CUSTOMER][POSITIVE] OK then thank you for that and thank you for helping me today bye bye take care.
[AGENT][POSITIVE] OK, you take care, Ms. [PII]. Thank you for calling APL. Bye-bye. There's nothing else I can help you?
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] Yeah, bye bye bye bye.
[CUSTOMER][NEUTRAL] Yeah, nothing. Thank you.
[AGENT][NEUTRAL] OK. Bye-bye, ma'am.