AccountId: 011433970860
ContactId: b73d0efa-b1f9-46c5-860c-94721ddb6a8e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 213979 ms
Total Talk Time (AGENT): 87582 ms
Total Talk Time (CUSTOMER): 60028 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/10/b73d0efa-b1f9-46c5-860c-94721ddb6a8e_20250310T13:27_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII], and I'm calling on behalf of the provider. I was looking for a claim status for a medical claim.
[AGENT][NEUTRAL] I'm sure, [PII], I can assist you with claim status. Um first, I'll need a good callback number just in case we're disconnected.
[CUSTOMER][NEUTRAL] Uh sure. It's uh [PII].
[AGENT][NEUTRAL] Thank you. Now, I need the policy number, please.
[CUSTOMER][NEUTRAL] It's 02298368.
[AGENT][NEUTRAL] And please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] It's uh [PII]. Date of birth [PII].
[AGENT][NEUTRAL] OK, thank you. Now I need the date of service and bill charges on the claim, please.
[CUSTOMER][NEUTRAL] It's uh [PII] and the charge amount is $300.
[AGENT][NEUTRAL] Oh, OK. You said the date of service was [PII] and the total bill charges is $300?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, I'm not showing that claim on file.
[CUSTOMER][NEUTRAL] Oh, and was the patient active during that date?
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] Yes, I'm showing that the patient was active on that date of service.
[CUSTOMER][NEUTRAL] Uh, may I have that effective date and termination date?
[AGENT][NEUTRAL] Um, yes, and just let me advise you that verification of coverage does not guarantee payment of claims. The effective date on the policy was [PII], and the policy, um, let's see, it lapsed. It expired on [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Fine. And may I know the time the following limits to submit the claim?
[AGENT][NEUTRAL] There's no timely filing limit?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And can you, uh, do you guys have a fax number to submit the claim?
[AGENT][NEUTRAL] Um, yes, the fax number is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII] and please attention it to the claims department.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] claims department.
[CUSTOMER][NEUTRAL] OK. And uh can you also please verify the claim mailing address?
[AGENT][NEUTRAL] Yes, my mom.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK, that mailing address for claims is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the zip code is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK. OK then, thank you so very much. Uh, that's all I need for today.
[AGENT][POSITIVE] OK. Well, since there isn't anything else I can assist you with, [PII], I thank you for calling APL. You have a great day. Mm bye.
[CUSTOMER][POSITIVE] Same to you. Take care. Bye.
[AGENT][POSITIVE] Mhm. Thank you.