AccountId: 011433970860
ContactId: ba22917e-416f-47a9-b862-975ea6a44af2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 332220 ms
Total Talk Time (AGENT): 152192 ms
Total Talk Time (CUSTOMER): 129610 ms
Interruptions: 1
Overall Sentiment: AGENT=0.9, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/06/ba22917e-416f-47a9-b862-975ea6a44af2_20250106T17:19_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from provider's office to check on the claim status.
[AGENT][POSITIVE] It would be my pleasure to help you with claim status. [PII], what's a good callback number?
[CUSTOMER][NEUTRAL] My
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] The callback number will be [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, [PII]. What is the policy number for the patient?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] The policy number will be
[CUSTOMER][NEUTRAL] 018
[CUSTOMER][NEUTRAL] 858
[CUSTOMER][NEUTRAL] 98
[AGENT][NEUTRAL] And the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] The patient's name will be [PII], and the patient's date of birth is
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] And do you have a claim number or date of service?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I have the date of service. It's uh [PII].
[AGENT][NEUTRAL] OK, bear with me just one moment. I don't have a claim on file for 11-13-24, but Mr. [PII]'s policy turned on.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] On
[AGENT][NEUTRAL] 12-1-2022, so I'm going to check to see if he had other coverage for that date.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm. So may I know the effective date?
[AGENT][NEUTRAL] The effective date on this policy is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Now, I don't have any of the coverage for Mr. [PII], and we do not have a claim on file for 11-13-24.
[CUSTOMER][NEUTRAL] Why
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. Also, could you please spell out your name?
[AGENT][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] And [PII], if you need a reference number, it would be my name in today's date.
[CUSTOMER][NEUTRAL] Mhm. But I do.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, but um I do see that uh
[CUSTOMER][NEUTRAL] Uh, the claim is partially paid by BCBS and submitted to uh APO. So you're stating that, uh,
[CUSTOMER][NEGATIVE] The patient is dumped, right?
[AGENT][NEUTRAL] That is correct. We do not have a claim on file and the policy termed on [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, OK, then. Thank you for your assistance, [PII]. I do have one more claim. Could you be able to assist me for the same?
[AGENT][POSITIVE] Is it for the same patient or different patient? and I'll be happy to assist you.
[AGENT][NEUTRAL] Is it for a different patient or same patient?
[CUSTOMER][NEUTRAL] It's for uh
[CUSTOMER][NEUTRAL] It's for different patient.
[AGENT][POSITIVE] Alright [PII], I'll be happy to assist you with another patient's claim status. What is that policy number?
[CUSTOMER][NEUTRAL] talking
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] The policy number is 157.
[CUSTOMER][NEUTRAL] 3001.
[AGENT][NEUTRAL] And that patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] The patient's name is [PII], and the patient's date of birth is [PII].
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] Give me just one moment.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Me
[AGENT][NEUTRAL] And that data service please, sir.
[CUSTOMER][NEUTRAL] The rate of service is [PII] for the bill amount of $114 even.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And you said the date of service is [PII]. I'm sorry, [PII].
[CUSTOMER][NEUTRAL] said
[CUSTOMER][NEUTRAL] No, it's
[CUSTOMER][NEUTRAL] [PII], yes.
[AGENT][NEUTRAL] OK, so for [PII] I do not have a claim on file for [PII]. His policy is active for that data service.
[CUSTOMER][NEUTRAL] Mhm. So may I know the effective and term date?
[AGENT][NEUTRAL] Sure, the effective date is [PII].
[AGENT][NEUTRAL] And the policy is active.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm. Also, may I know the payer ID number as well?
[AGENT][NEUTRAL] The payer ID is [PII].
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, so can we submit the claim electronically?
[AGENT][NEUTRAL] You can submit it electronically or it can also be faxed directly to our claims department.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The
[CUSTOMER][NEUTRAL] Uh, so may I know the fax number also?
[AGENT][NEUTRAL] Fax number is [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] OK. And also may I know the claim mailing address?
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] Zip code is [PII].
[CUSTOMER][NEUTRAL] Mhm. OK. And uh also, may I know the timely filing limit to submit the claim?
[AGENT][NEGATIVE] No timely filing.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, then thank you for your assistance, [PII], and is the call reference number is the same?
[AGENT][NEUTRAL] Call reference numbers my name and today's date.
[CUSTOMER][POSITIVE] OK, then. Thank you for assistance, [PII]. Have a great day and great year. Bye-bye.
[AGENT][POSITIVE] It's been my pleasure to assist you and thank you for calling APL. You have a wonderful day as well.
[CUSTOMER][NEUTRAL] Bye bye.
[AGENT][NEUTRAL] Bye bye