AccountId: 011433970860
ContactId: b0f8f658-0811-44f8-a5f8-900d6852b388
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1219560 ms
Total Talk Time (AGENT): 216316 ms
Total Talk Time (CUSTOMER): 468617 ms
Interruptions: 1
Overall Sentiment: AGENT=0.3, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/05/b0f8f658-0811-44f8-a5f8-900d6852b388_20250605T13:58_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I'm calling for provider to check on a claim status. Please be informed that this call is being recorded. I order for training and quality purposes. May I know if I can help you with patient information of the provide information?
[AGENT][NEUTRAL] Um, yes, I can help you with claim status. Could I get a good callback number, [PII]?
[CUSTOMER][NEUTRAL] So, the callback number will be [PII]. No extension direct line.
[CUSTOMER][NEUTRAL] OK, you know what.
[AGENT][NEUTRAL] And policy number of the patient?
[CUSTOMER][NEUTRAL] So, the patient's policy number will be 2, it is 02581622.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] What was the number again?
[CUSTOMER][NEUTRAL] It is 02581622.
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] So, the patient's first name is [PII]. The last name is [PII]
[CUSTOMER][NEUTRAL] And the date of birth will be [PII].
[AGENT][NEUTRAL] The date of service and bill charges?
[CUSTOMER][NEUTRAL] Sure, the data service was [PII] with the total charges, uh, just a moment for the total charges.
[CUSTOMER][NEUTRAL] The total charges were $330 even.
[AGENT][NEUTRAL] I don't have a claim on file. Can you resubmit?
[CUSTOMER][NEUTRAL] Uh, just give me a moment.
[CUSTOMER][NEUTRAL] OK, so just wanted a few details like, uh, is the patient active in the data service?
[AGENT][NEUTRAL] Yes, policies effective [PII].
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] 11225. Got it. And uh still active. Uh do you have any like um
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] You're the secondary for the patient, is that correct?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Just a moment, I'm making a note.
[CUSTOMER][NEUTRAL] Do you have any information on when was the last coordination of benefits updated?
[AGENT][NEUTRAL] Um, I show that major medical is EVHC.
[AGENT][NEUTRAL] I'm not sure what that what that is. E as in Echo, V as in Victor, H as in Hotel, C as in Charlie.
[CUSTOMER][NEUTRAL] 7
[CUSTOMER][NEUTRAL] OK, so when it was updated, do you have any information on that?
[AGENT][NEUTRAL] Uh, no, it's just, it's in our system just loaded as that's the primary.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No problem. So what is the claim submission time you're filing?
[AGENT][NEUTRAL] Uh, there's no submit there's no timely filing limit. You can submit any time.
[CUSTOMER][NEUTRAL] OK. OK. And the claim submission mailing address will be [PII]. Is that correct?
[AGENT][NEUTRAL] Um, no, uh, the claim's mailing address is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, just a moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, it was.
[CUSTOMER][NEUTRAL] And the zip code is [PII].
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] And the payer ID will be 64556.
[AGENT][NEUTRAL] Your ID is 60801.
[CUSTOMER][NEUTRAL] 60801.
[CUSTOMER][NEUTRAL] And uh what is the preferred mode of submission?
[AGENT][NEUTRAL] Um, whatever is easiest.
[AGENT][NEUTRAL] We have a fax number too if you need that.
[CUSTOMER][POSITIVE] Uh, no problem, I'll keep it.
[CUSTOMER][NEUTRAL] As upon the provider. So, uh.
[CUSTOMER][NEUTRAL] As I can check. OK, so would you be the caller reference number?
[AGENT][NEUTRAL] It's my name and today's date.
[CUSTOMER][NEUTRAL] OK, got it. So it will be [PII] 6525.
[AGENT][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] OK, so [PII], just wanted to like, like for how many claims you can help me the call.
[AGENT][NEUTRAL] Um, as many as you have.
[CUSTOMER][NEUTRAL] OK, actually I was having 8 claims.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, let me get the.
[CUSTOMER][NEUTRAL] So let's move on to the next one.
[AGENT][NEUTRAL] OK, what's that number?
[CUSTOMER][NEUTRAL] Sure. The policy number is 1256082.
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] Sure, the patient's first name is [PII] and the last name is [PII]
[CUSTOMER][NEUTRAL] And the date of birth will be [PII].
[AGENT][NEUTRAL] And the date of service and bill charges?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] That was [PII] with the total charges of
[CUSTOMER][NEUTRAL] $210 even.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] We can
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] And for this one I have just called you to get the copy of your and verify a few details which I'm having with me.
[AGENT][NEUTRAL] OK, um.
[CUSTOMER][NEUTRAL] 875.
[AGENT][NEUTRAL] It looks like we received the claim on.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And that was paid on [PII].
[AGENT][NEUTRAL] And we made a payment of $25.
[CUSTOMER][POSITIVE] I think they are right.
[AGENT][NEUTRAL] And you said you needed the EOB.
[CUSTOMER][NEUTRAL] No patient responsibility and what check number 358-6246 and the payment clearga date was [PII].
[CUSTOMER][NEUTRAL] And the claim number was uh.
[CUSTOMER][NEUTRAL] So it was a claim number claim was uh 3586246 and the check number is 2037692. Is that correct? Uh.
[AGENT][POSITIVE] Yes, yes, that's correct.
[CUSTOMER][NEUTRAL] And it was a single check.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, uh, just give me a moment, [PII].
[AGENT][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, so can you fax us the copy of your?
[AGENT][POSITIVE] Yes, for sure, thanks.
[CUSTOMER][NEUTRAL] So fax number is
[CUSTOMER][NEUTRAL] [PII] and the attention will be towards patient's account number.
[AGENT][NEUTRAL] What's the what?
[CUSTOMER][NEUTRAL] The patient account number.
[AGENT][NEUTRAL] The patient account number?
[CUSTOMER][POSITIVE] Patient's account number, that's correct.
[AGENT][NEUTRAL] Remember.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK, so I can help you with that number, no problem. It is 244-08V as in Victor 9833.
[AGENT][NEUTRAL] OK. Give me one moment. I'll get that faxed. I'm gonna do it right now. If you'll just give me a moment, OK?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Is it.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] If you need any information from me.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, you have the next account number or policy number, next patient?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, uh,
[CUSTOMER][NEUTRAL] Just a moment, let me open it up.
[CUSTOMER][NEUTRAL] OK, so.
[CUSTOMER][NEUTRAL] Hey it is and.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So the member ID is a bit long this time. It is 02203919 M as in Mike, L as in Lima 8.
[AGENT][NEUTRAL] The patient name and date of birth?
[CUSTOMER][NEUTRAL] It is [PII].
[CUSTOMER][NEUTRAL] And the date of birth will be [PII].
[AGENT][NEUTRAL] Day of service and bill charges.
[CUSTOMER][NEUTRAL] So, the date of service is February.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] With the total charges of 800.
[CUSTOMER][NEUTRAL] $49.56.
[AGENT][NEUTRAL] Do you have the claim number for this charge?
[CUSTOMER][NEUTRAL] Right
[CUSTOMER][NEUTRAL] Um, as I can check.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] I just, I was just curious because you had the last one, so I didn't know if you had claim numbers for all of these and just needed the EOBs.
[CUSTOMER][NEUTRAL] I have a
[CUSTOMER][NEUTRAL] Nope, uh, every claim has their own stories.
[AGENT][NEUTRAL] OK, OK.
[CUSTOMER][NEUTRAL] For this one actually, I don't have any information.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And what was, I'm sorry, what was the bill charges again?
[CUSTOMER][NEUTRAL] Sure. The total bill charges were $849.56.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Do you have any of the codes? They've got several um charges for the state.
[AGENT][NEUTRAL] Like the procedure codes or?
[CUSTOMER][POSITIVE] Yes, I can surely check that.
[CUSTOMER][NEUTRAL] Yes, uh, I have some, uh, uh, OK, so we have two procedure codes. One is uh 99222.
[CUSTOMER][NEUTRAL] And the second one will be uh 99232.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Like
[CUSTOMER][NEUTRAL] It.
[AGENT][NEUTRAL] OK, looks like we received this claim on
[CUSTOMER][NEUTRAL] M15.
[AGENT][NEUTRAL] 328 25, processed on [PII].
[AGENT][NEUTRAL] We made a payment of 4898, single check.
[AGENT][NEUTRAL] And the check number was 230 I'm sorry, 2036446.
[CUSTOMER][NEUTRAL] Just
[CUSTOMER][NEUTRAL] $10.
[CUSTOMER][NEUTRAL] OK. So, uh, just need to know a few things. Uh, you received it on uh [PII], and, it was processed and paid on [PII]. Is that correct?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK. What is the allowed amount?
[AGENT][NEUTRAL] Um, this is a secondary policy, so we, we just, there's not an allowed amount, we just pay what's according to the policy.
[CUSTOMER][NEUTRAL] OK, so, uh.
[CUSTOMER][NEUTRAL] We can say that uh there is no patient responsibility is that correct?
[AGENT][NEUTRAL] Um, again, it's a secondary policy, so we can't instruct on patient responsibility. We just, we'll process the claim according to the plan.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So it was a single check or a bulk check?
[AGENT][NEUTRAL] Single
[CUSTOMER][NEUTRAL] And to which address you mailed to?
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Really thank you for for this information. Let me go ahead and verify the patient account number really fast.
[CUSTOMER][NEUTRAL] Is the patient account number [PII]?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, do you have a payment clear cash rate?
[AGENT][NEUTRAL] Uh, now I show the check is still outstanding. Do you want us to see, send for a void and reissue?
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK, no problem, so it is not clear yet.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, and can you fax us the copy of UB?
[AGENT][NEUTRAL] Uh, yes, same fax number.
[CUSTOMER][NEUTRAL] Same fax number and that is towards patient number.
[AGENT][NEUTRAL] OK. Uh, let me do that real quick. Hold on one moment.
[CUSTOMER][NEUTRAL] So, uh, according to you, what will be the dinner on time?
[AGENT][NEUTRAL] For the facts
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] It, I'm sending it right now, so it just should take about 5 minutes.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] For you to receive it.
[CUSTOMER][NEUTRAL] OK, got it.
[AGENT][NEUTRAL] on how fast your services are.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] So let let me send it real quick. Hold on one moment, OK?
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK. Do you have the next claim?
[CUSTOMER][NEUTRAL] Uh yes. Uh, for this one, what was the claim number?
[CUSTOMER][POSITIVE] Thank you. And may I know?
[AGENT][NEUTRAL] My number is.
[AGENT][NEUTRAL] 3,583,200.
[CUSTOMER][NEUTRAL] 3,583,200.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, and the reference number will be your name and today's date. OK, uh, [PII], um, actually.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] I won't be able to get the complete status of all the claims, but, uh, really thank you for helping me with the claims and have a wonderful day ahead.
[AGENT][POSITIVE] OK, thank you for calling APL. I hope you do too.
[CUSTOMER][NEUTRAL] a
[CUSTOMER][NEUTRAL] You too bye bye.