AccountId: 011433970860
ContactId: b7a14809-99d4-4648-a2f1-5c742e0b2fae
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 321529 ms
Total Talk Time (AGENT): 118535 ms
Total Talk Time (CUSTOMER): 122157 ms
Interruptions: 2
Overall Sentiment: AGENT=0.6, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/28/b7a14809-99d4-4648-a2f1-5c742e0b2fae_20250428T22:47_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], this is [PII] calling from provider's office, and I'm checking on a claim.
[AGENT][NEUTRAL] OK, I could check on a claim for you. uh, [PII], can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes, it's uh [PII]. It's a direct line.
[AGENT][NEUTRAL] Thank you and then do you have that policy number?
[CUSTOMER][NEUTRAL] Uh, patient policy number, right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Just a second. It's uh 02255705, M like Mary, L like Lima, number 8.
[AGENT][NEUTRAL] OK, and uh what was the name and date of birth for the member please?
[CUSTOMER][NEUTRAL] Uh [PII]'s date of birth is [PII].
[AGENT][POSITIVE] Perfect, thank you for verifying that uh what was the date of service for this claim?
[CUSTOMER][NEUTRAL] [PII] and it's for $190.96.
[AGENT][NEUTRAL] I'm sorry, uh, that was $190.96.
[CUSTOMER][NEUTRAL] 96 cents.
[AGENT][POSITIVE] OK, got it thank you one moment please.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK, and I'm sorry, that was [PII]?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, so I'm not showing that we've received any claims for that date of service for this number.
[CUSTOMER][NEUTRAL] Actually, we did call on for [PII]. They uh they said no claim on file and we did uh rebuild the claim. Can you uh confirm the uh electronic payer ID once?
[AGENT][NEUTRAL] Yes, our payer ID is 60801.
[AGENT][NEUTRAL] And I've also got um mailing address and the fax number. I'm sorry?
[CUSTOMER][NEUTRAL] Uh, can you repeat that? Your voice broke.
[CUSTOMER][NEUTRAL] Can you repeat the payer ID?
[AGENT][NEUTRAL] Yes, 60801.
[CUSTOMER][NEUTRAL] OK. And the fax number and the mailing address, please, as well.
[AGENT][NEUTRAL] Of course, uh, that fax number is [PII].
[AGENT][NEUTRAL] 3659423
[CUSTOMER][NEUTRAL] OK, right, just a second, because we, uh, received a correspondence, we received only the claim form back to us. So, uh, all the member information that I gave is correct, right? Member ID name and date of birth?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] Is the patient a subscriber or is uh is the patient uh uh
[AGENT][NEUTRAL] No, um.
[AGENT][NEUTRAL] Let me give me just a moment, she is not the subscriber the subscriber is um.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII], it's a spouse.
[CUSTOMER][NEUTRAL] OK. Uh, just a second. Let me check.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, I think that's the issue. Uh, we have sent it as the subscriber as patient.
[CUSTOMER][NEUTRAL] OK, so for, for the subscriber information you do not need any uh uh date of birth for the subscriber, right?
[AGENT][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] No, not for filing claims just, uh, just [PII]'s information.
[CUSTOMER][NEUTRAL] OK, got it. Just a sec. And what's the timely finding limit for the first claim?
[AGENT][NEGATIVE] There's no timely filing limit.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Just a second.
[CUSTOMER][NEUTRAL] And if you're sending a thanks, uh, whose attention should we send it to?
[AGENT][NEUTRAL] Uh, claims department.
[CUSTOMER][NEUTRAL] OK, and uh may I also know the effectiveness and if there if there is any termination date for this policy.
[AGENT][NEUTRAL] Sure, so the effective date was [PII].
[AGENT][NEUTRAL] And it is currently active.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] So there's no termination date currently, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, got it. Just a second. And also, can you uh repeat the uh mailing address once? I'm sorry, miss that.
[AGENT][NEUTRAL] Oh sure, uh, mailing address is [PII].
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] And that is in [PII].
[AGENT][NEUTRAL] Zip code is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, go ahead, just a second.
[CUSTOMER][POSITIVE] OK, thank you so much for all the information. Uh, may I also get the call reference number?
[AGENT][NEUTRAL] Of course. Was there anything else I can help you with? Sure, that would just be my first name, last initial, and today's date. And so my name is spelled [PII] Last [PII]
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][POSITIVE] OK, good, thank you so much for it. It was really nice talking to you and have a great day.
[AGENT][POSITIVE] Of course. You too, thank you. Bye bye.
[CUSTOMER][NEUTRAL] Bye bye bye bye.