AccountId: 011433970860
ContactId: ba4de20f-4237-431b-9c55-cca173ba6fa5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 382920 ms
Total Talk Time (AGENT): 155697 ms
Total Talk Time (CUSTOMER): 125708 ms
Interruptions: 3
Overall Sentiment: AGENT=0.6, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/03/ba4de20f-4237-431b-9c55-cca173ba6fa5_20250203T19:16_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. With whom am I speaking and how may I help you?
[CUSTOMER][NEUTRAL] Uh, hi, [PII]. This is [PII] here. I'm calling from the provider office to check the claim.
[AGENT][NEUTRAL] OK, what was your name?
[CUSTOMER][NEUTRAL] Hold on.
[CUSTOMER][NEUTRAL] Uh [PII].
[AGENT][NEUTRAL] [PII]? OK, and what's a good call back number for you, [PII]?
[CUSTOMER][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] Uh, it's [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and you're calling to check claim status. I can help you with that today. What's the policy number?
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] Sure. It's uh 02477911.
[AGENT][NEUTRAL] And what is the data service and charge amount?
[CUSTOMER][NEUTRAL] What.
[CUSTOMER][NEUTRAL] Uh, it's, um,
[CUSTOMER][NEUTRAL] [PII], with the bill amount of $398.02.
[AGENT][NEUTRAL] Thank you for that information. [PII] for $398.02. 1 moment while I locate that. Verification of coverage does not guarantee the payment of a claim. What is the member's name and date of birth?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Sure. The patient name is [PII].
[CUSTOMER][NEUTRAL] [PII] and his date of birth is [PII].
[AGENT][POSITIVE] Thank you for that information and one moment while I check the status of this coin.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, there is no claim on file for that data service. We do not have a timely filing limit, so you still can file that claim. Is there anything else I can help you with today?
[CUSTOMER][NEUTRAL] Uh, one moment. I think I previously saw the claim has been received or not. One moment.
[CUSTOMER][NEUTRAL] OK, so there is no information about that. So may I have the member policy effective date and termination date?
[AGENT][NEUTRAL] The member has an effective date of [PII].
[AGENT][NEUTRAL] [PII] and it's currently active?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK. Thank you so much.
[AGENT][NEUTRAL] Uh huh, is there anything else I can help you with?
[CUSTOMER][NEUTRAL] And may I know the claim mailing address?
[AGENT][NEUTRAL] OK, sure.
[CUSTOMER][NEUTRAL] Yeah, claim mailing address.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] I have
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Oh, I'm sorry. Can you spell that for me, please?
[AGENT][NEUTRAL] Spell what, sir?
[CUSTOMER][NEUTRAL] The [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And the zip code is [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII]. Is there anything else I can help you with?
[CUSTOMER][NEUTRAL] Uh, the payer ID, please.
[AGENT][NEUTRAL] Uh, that is 60801.
[CUSTOMER][POSITIVE] OK, thank you so much. And there has been one more claim to work with. So, could you able to help me with that claim too?
[AGENT][NEUTRAL] I can only assist you with one other claim. I can only assist you with one other claim after I put a note on this claim. So I'm gonna place you on a brief hold. When I come back to the line, please make sure you have that patient's information ready to go, OK? I need the ID number and the name. I'll be right back. One moment.
[CUSTOMER][NEUTRAL] It's for the different patient actually.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Oh thanks.
[AGENT][NEGATIVE] Don't make sense.
[AGENT][NEUTRAL] Oh gosh.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Please
[AGENT][NEUTRAL] I really
[AGENT][NEUTRAL] ready.
[AGENT][NEUTRAL] You gotta watch mhm.
[AGENT][POSITIVE] Thank you for patiently waiting. What is the next member's the last member's, uh, ID number?
[CUSTOMER][NEUTRAL] Sure, it's uh
[CUSTOMER][NEUTRAL] 024826667.
[AGENT][NEUTRAL] And what is the member's name and date of birth?
[CUSTOMER][NEUTRAL] The patient name is [PII].
[CUSTOMER][NEUTRAL] And his date of birth is [PII].
[AGENT][NEUTRAL] What is the uh data service and charge amount?
[CUSTOMER][NEUTRAL] Uh, [PII] with the bill amount of $281.82.
[AGENT][NEUTRAL] OK, [PII] for $281.82. All right, verification coverage does not guarantee the payment of a claim. This member has ineffective date. The effective date is [PII], and it's currently active.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] [PII] currently active. There is no claim on file for this data service. There is no timely filing, same claims mailing address, same payer ID. Alright, anything else I can help you with?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK. Thank you so much and uh
[CUSTOMER][NEUTRAL] Yeah, call reference, please.
[AGENT][POSITIVE] It'll be my name [PII], last initial [PII] and today's date. Thank you [PII] for calling APL. Have a great day and stay safe. Bye bye.
[CUSTOMER][POSITIVE] Thank you so much. Have a good day. Bye-bye.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][POSITIVE] Thank you