AccountId: 011433970860
ContactId: aca30fa8-6446-4bb1-8cdd-02ddad9887bc
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 425070 ms
Total Talk Time (AGENT): 158284 ms
Total Talk Time (CUSTOMER): 97484 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/07/aca30fa8-6446-4bb1-8cdd-02ddad9887bc_20250207T15:11_UTC.wav
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[AGENT][NEUTRAL] Morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, sorry, your name?
[AGENT][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Uh, can you hear me?
[AGENT][NEUTRAL] Barely.
[CUSTOMER][NEUTRAL] Can you hear me now?
[AGENT][POSITIVE] That, that is a little better.
[CUSTOMER][NEUTRAL] Yeah, hi, my name is uh [PII] calling on behalf of office.
[AGENT][NEUTRAL] OK, [PII]. How can I help you today?
[CUSTOMER][NEUTRAL] I just put a general status the claim.
[AGENT][NEUTRAL] I'm sorry, did you say you're needing claim status?
[CUSTOMER][NEUTRAL] Yeah, no, my name is [PII]. It's [PII].
[AGENT][POSITIVE] Yes, ma'am. I got that. How can I help you today?
[CUSTOMER][NEUTRAL] Yeah, I'm checking on the claim status.
[AGENT][NEUTRAL] You have one claim to check status on, is that correct?
[CUSTOMER][NEUTRAL] No, it's 2.
[AGENT][NEUTRAL] For the same patient or different patients?
[CUSTOMER][NEUTRAL] It it's for the same patient.
[AGENT][POSITIVE] Yes, ma'am. I can help you with that. And what is your callback number?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Thank you and [PII], my name is [PII] You will use my name along with today's date as your call reference number for each one. Also, any information that I provide for you will be a verification of benefits and not a guarantee of payment. And if we do have the claims on file and you need a copy of either explanation of benefits, you may go to our portal to print those directly by going to the website secured.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And what is your patient's policy number, please?
[CUSTOMER][NEUTRAL] Yeah one moment.
[CUSTOMER][NEUTRAL] Uh, sure. The policy number is 023.
[CUSTOMER][NEUTRAL] 23237.
[AGENT][NEUTRAL] Say that one more time please, [PII].
[CUSTOMER][NEUTRAL] It's
[CUSTOMER][NEUTRAL] 023 23 237
[AGENT][POSITIVE] Thank you one moment.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And any information uh just one second, [PII]. I'm sorry, one moment.
[CUSTOMER][POSITIVE] Yeah, sure take your time.
[AGENT][NEUTRAL] And any information [PII] that I do provide for you today would be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth?
[CUSTOMER][NEUTRAL] Patient's first name is [PII] and the last name is [PII]. And the date of birth is [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And what is the first day of service and total bill amount?
[CUSTOMER][NEUTRAL] Yeah, it's for.
[CUSTOMER][NEUTRAL] [PII] and the total sales amount $129.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, and you said 9-16 of 2024. Is that correct?
[CUSTOMER][POSITIVE] Yeah, yeah, that's correct.
[AGENT][NEUTRAL] OK, there is no claim on file for her for that data service.
[CUSTOMER][NEUTRAL] Uh OK. Uh, may I know the policy effective and termination date?
[AGENT][NEUTRAL] Effective date is [PII], term date [PII].
[CUSTOMER][NEUTRAL] OK, and may I know the electronic payer ID?
[AGENT][NEUTRAL] 60801.
[CUSTOMER][NEUTRAL] And the call reference number for this.
[AGENT][NEUTRAL] Would be my name and today's date as I explained to you.
[CUSTOMER][NEUTRAL] It's [PII]
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I have another date of service for the same members for [PII] and the total charge amount $680.
[AGENT][POSITIVE] Thank you, one moment.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] 115 of 2024. Is that correct?
[CUSTOMER][POSITIVE] Yeah, that's correct.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so there is also no claim on file for her for this data service either.
[CUSTOMER][NEUTRAL] OK, may I know the timely filing limit for this?
[AGENT][NEGATIVE] There is no timely filing, no timely filing limits.
[CUSTOMER][NEUTRAL] To submit a claim?
[CUSTOMER][NEUTRAL] OK, uh may I know the call reference number for this?
[AGENT][NEUTRAL] We must receive.
[AGENT][NEUTRAL] Yes, ma'am, but first, we, you must also send us a copy of the primary insurance company's explanation of benefits along with the claim for review.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And as I explained, the reference number is my name and today's date.
[AGENT][NEUTRAL] And our portal website to check claim status is [PII].
[CUSTOMER][POSITIVE] OK, thank you, [PII] for putting the information. Have a great day.
[AGENT][POSITIVE] Yes, ma'am. You're very welcome. So is there anything else I can help you with today, [PII]?
[CUSTOMER][POSITIVE] No, no, I have got all the information that I wanted.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] OK, well then, thank you again for calling APL and I hope you have a nice weekend.
[CUSTOMER][NEUTRAL] Yeah, you too. Bye-bye.
[AGENT][POSITIVE] Thank you. Bye-bye.