AccountId: 011433970860
ContactId: b68e2aeb-05f9-40c6-977c-592e1c4062a2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 708510 ms
Total Talk Time (AGENT): 308354 ms
Total Talk Time (CUSTOMER): 153365 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/20/b68e2aeb-05f9-40c6-977c-592e1c4062a2_20250620T13:49_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] I don't have to name status.
[AGENT][NEUTRAL] I'm sorry, what was your name?
[CUSTOMER][NEUTRAL] It's [PII]
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] It's [PII]
[AGENT][NEUTRAL] OK, thank you and [PII], what is your callback number?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Thank you. And you said that was [PII], [PII], is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, thank you. And you're needing claim status, is that also correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes, ma'am, I can help you with that. And how many claims, [PII], do you have to check status on?
[CUSTOMER][NEUTRAL] I have to for the day.
[AGENT][NEUTRAL] Um, how many?
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] Are they for the same patient or different patients?
[CUSTOMER][NEUTRAL] Oh, it's for a different patient.
[AGENT][POSITIVE] Yes, I can help you with both, and [PII], you will use my name that I gave you along with today's date as your call reference number for each one.
[CUSTOMER][NEUTRAL] Uh, please spell your name?
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] Also, remit any information provided on the claims will be a verification of benefits and not a guarantee of payment. And lastly, if we do have the claims on file and you need a copy of the explanation of benefits, you may print them once you have the claim number by going to our portal which is located at [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And what is your first patient's policy number, please?
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] It's 025658550.
[AGENT][NEUTRAL] Did you say 02565850?
[CUSTOMER][POSITIVE] Yes, it's right.
[AGENT][POSITIVE] Thank you, one moment.
[AGENT][NEUTRAL] And [PII], uh, what is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] It's [PII] and date of birth is [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And what is the data service and total bill amount for her, please?
[CUSTOMER][NEUTRAL] It's April 9, 2025 for the bill amount of $324.
[AGENT][NEUTRAL] I'm sorry, what is the bill amount?
[CUSTOMER][NEUTRAL] It's $324.
[AGENT][NEUTRAL] And the date of service again was 4-9-2025. Is that correct?
[CUSTOMER][POSITIVE] Yes, it's right.
[AGENT][POSITIVE] Thank you. One moment.
[AGENT][NEUTRAL] And one more time, the build amount.
[CUSTOMER][NEUTRAL] It's $24.
[AGENT][NEUTRAL] OK, so [PII], we do not have a claim on file for her for data serves 49-2025 in the amount of $324.
[AGENT][NEUTRAL] So when you do submit the claim to APL for review, you will need to also send us a copy of the primary insurance company's explanation of benefits along with the claim.
[AGENT][NEUTRAL] And then again, as I stated, once we've processed the claim, you can check claim status in our portal by going to that website at [PII].
[CUSTOMER][NEUTRAL] OK, sir. And uh uh may I also have this members effective and term date?
[AGENT][NEUTRAL] This policy, this supplemental policy is active.
[AGENT][NEUTRAL] The effective date on it is [PII].
[CUSTOMER][NEUTRAL] It's not a date.
[AGENT][NEUTRAL] No termination date, the policy is active.
[CUSTOMER][NEUTRAL] OK. And uh may I also have the time returning to submit the claim?
[AGENT][NEGATIVE] There is no timely filing limit.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And do you have the PID email address?
[AGENT][NEUTRAL] I'm sorry, what was your question?
[CUSTOMER][NEUTRAL] May I have the pay ID and mailing address?
[AGENT][NEUTRAL] Payer ID is 60801.
[AGENT][NEUTRAL] Claims mailing address is [PII].
[AGENT][NEUTRAL] And the zip code is [PII], excuse me, [PII].
[CUSTOMER][NEUTRAL] Oh, can I repeat it once again?
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK. The zip code is [PII], sir, right?
[AGENT][NEUTRAL] No, ma'am. The zip code is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] OK. Thank you so much for that.
[AGENT][NEUTRAL] You're welcome. And is there anything else you need on this member's policy?
[CUSTOMER][NEUTRAL] Um, that's fine for this number and.
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK. And what is your next patient's policy number, [PII]?
[CUSTOMER][NEUTRAL] It's 01826104 M as in Mike L as in Lima 7.
[AGENT][POSITIVE] Thank you. One moment.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] And your patient's name and their date of birth.
[CUSTOMER][NEUTRAL] It's
[CUSTOMER][NEUTRAL] [PII] and the date of birth is [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And what is the date of service and total bill amount?
[CUSTOMER][NEUTRAL] It's [PII] for the bill amount of $386.
[AGENT][NEUTRAL] Again, that was 372025 for $386. Is that correct?
[CUSTOMER][POSITIVE] Yes. Yes, it's right.
[AGENT][POSITIVE] Thank you. OK, one moment.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] So this claim was also received this claim was received [PII], the received date was [PII].
[AGENT][NEUTRAL] It was processed on [PII].
[AGENT][NEUTRAL] The claim number is 3,589,070.
[AGENT][NEGATIVE] It was denied.
[AGENT][NEUTRAL] Code 9
[CUSTOMER][NEUTRAL] Yes, my name.
[AGENT][NEUTRAL] What was, I'm sorry, what was your question?
[CUSTOMER][NEUTRAL] Uh, just a moment.
[CUSTOMER][NEUTRAL] Uh, for this claim, uh, we have, we submitted this claim on, uh,
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEGATIVE] That has not been received.
[CUSTOMER][NEUTRAL] OK. Uh, can I resend me this one then?
[AGENT][NEUTRAL] You may file on a, yes, this claim may be some.
[AGENT][NEUTRAL] OK, so you already know the reason for the denial on the claim number that I gave you, is that correct?
[CUSTOMER][NEUTRAL] Oh yes, we have that U be on file.
[AGENT][NEUTRAL] OK, so the office visit is not covered under this member's plan and then for code 93,000, all we need is the primary insurance company's explanation of benefits.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] OK, thank you so much.
[AGENT][POSITIVE] You're very welcome, [PII]. Is there anything else?
[CUSTOMER][NEUTRAL] And.
[CUSTOMER][NEUTRAL] Uh, may I also have the, um, a payment for this number?
[AGENT][NEUTRAL] I'm, I'm sorry, I did not understand you.
[CUSTOMER][NEUTRAL] Uh, may I have the effective date for this number?
[AGENT][NEUTRAL] There is no term date. It is active with an effective date of [PII].
[CUSTOMER][POSITIVE] OK. Thank you so much. And everything will be remains the same, right? And the, the pay ID was 60801, is it right?
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][POSITIVE] Yeah, that's correct.
[AGENT][NEUTRAL] 60801.
[CUSTOMER][POSITIVE] Thank you so much for that and
[AGENT][NEUTRAL] And I
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And conference will be your name and today's time.
[AGENT][POSITIVE] Yes, ma'am, that is correct. Uh-huh.
[CUSTOMER][NEUTRAL] May I have your last name, [PII]?
[AGENT][NEUTRAL] [PII], and yours?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And again, [PII], is there anything else I can help you with?
[CUSTOMER][NEUTRAL] And
[CUSTOMER][POSITIVE] That's all for today. Uh thank you so much for asking. Have a wonderful day and happy weekend.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Well, you're very welcome. Yes, ma'am. I hope you have a nice excuse me, weekend as well, and thank you again for calling APL.
[CUSTOMER][NEUTRAL] Bye.
[AGENT][NEUTRAL] Uh-huh, bye-bye.