AccountId: 011433970860
ContactId: ad40ae5a-7bbe-4e95-89d8-05257e3f84f6
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 221779 ms
Total Talk Time (AGENT): 83770 ms
Total Talk Time (CUSTOMER): 97214 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/02/ad40ae5a-7bbe-4e95-89d8-05257e3f84f6_20250102T17:12_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Oh, good morning. Sorry, thank you for calling APL. How may I help you? I'm sorry.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] No, you're fine. Um, I'm looking for a claim status for a patient.
[AGENT][NEUTRAL] OK, I can help you with the claim status, and may I have your name and a good contact number?
[CUSTOMER][NEUTRAL] Uh, my name is [PII] [PII] and what was your name?
[AGENT][NEUTRAL] My name is [PII].
[CUSTOMER][POSITIVE] Thank you [PII].
[AGENT][NEUTRAL] You're welcome, and [PII], may I have the member's policy number?
[CUSTOMER][NEUTRAL] It is 02341753.
[AGENT][POSITIVE] Thank you. Hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And may I have the date of service for the claim and the total bills?
[CUSTOMER][NEUTRAL] It's [PII] and he has two claims for that date. Um, one is for the main surgeon and one is for the assistant. The main surgeon is $7860.
[AGENT][NEUTRAL] OK. And then what's the other one?
[CUSTOMER][NEUTRAL] Um, 5000 $5,896.
[AGENT][NEUTRAL] Thank you for that. And then can you verify the name of the provider's office on the claim?
[CUSTOMER][NEUTRAL] It is uh Doctor [PII], uh, Archway Orthopedics and Hand Surgery.
[CUSTOMER][NEUTRAL] They also have SDKP Enterprises.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let's see, hold on one moment.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] So we only received 20 well.
[AGENT][NEUTRAL] We only received one claim for that data service, but it's a different provider. What's your tax ID?
[CUSTOMER][NEUTRAL] Tax ID is, where did I put that? Oh, there it is. [PII].
[AGENT][NEUTRAL] Mhm. So we don't have a claim on file for you all yet.
[CUSTOMER][NEUTRAL] OK, and then, um, so we just send that to American Public Life, that's [PII] I'm sorry [PII] [PII].
[AGENT][NEUTRAL] Yes, that's correct. And there's no timely filing limit and the um let me check the effective date.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, the policy has been active since [PII], so it was active on your data service and it's still active.
[CUSTOMER][NEUTRAL] OK, so it's still active and then, um, I also have a fax number here. Am I allowed to fax it? I have [PII].
[AGENT][NEUTRAL] Yes, you can fax it. Um, we also have a payer ID if you'd like to send it electronically as well.
[CUSTOMER][NEUTRAL] OK, it's a secondary, so I'm gonna go ahead and fax it because sometimes the primary ELBs get lost in those.
[AGENT][NEUTRAL] Oh yeah.
[CUSTOMER][NEUTRAL] So, OK. Thank you, [PII]. Um, do you have a reference number for our call?
[AGENT][NEUTRAL] You're welcome. So no, there's no call reference number, but you can use my name in today's date. The first initial to my last name is [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you, [PII].
[AGENT][POSITIVE] You're very welcome and thanks for calling APL Jessica and Happy [PII].
[CUSTOMER][POSITIVE] Happy [PII].
[AGENT][POSITIVE] Thank you, bye bye.
[CUSTOMER][NEUTRAL] Bye bye.