AccountId: 011433970860
ContactId: bb81a29f-9657-4484-8fa2-d8629eb9070a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 995820 ms
Total Talk Time (AGENT): 343989 ms
Total Talk Time (CUSTOMER): 319611 ms
Interruptions: 2
Overall Sentiment: AGENT=0.8, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/18/bb81a29f-9657-4484-8fa2-d8629eb9070a_20250318T15:26_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 [PII], this is [PII] from providers software checking on the client status.
[AGENT][POSITIVE] OK, well, I'll be more than happy to help you with the claim status, [PII]. And may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Uh yeah, sure, it's [PII].
[AGENT][NEUTRAL] [PII], did you say [PII]?
[CUSTOMER][NEUTRAL] Mm, no, it's [PII].
[AGENT][NEUTRAL] And may I have the member's policy number?
[CUSTOMER][NEUTRAL] Um, yes, sure for the policy.
[CUSTOMER][NEUTRAL] 129.
[CUSTOMER][NEUTRAL] 052
[CUSTOMER][NEUTRAL] 5 M as in Mike, L as in Lima, number 7.
[AGENT][NEUTRAL] Thank you. Hold on one moment. And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] It's a [PII] and for the date of birth [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment and
[AGENT][NEUTRAL] May I have the date of service for the claim you want me to check on?
[CUSTOMER][NEUTRAL] It's [PII]. Can I get your name, please?
[AGENT][NEUTRAL] Sure, again, my name is [PII].
[CUSTOMER][POSITIVE] Thank you, ma'am.
[AGENT][NEUTRAL] You're welcome, and may I have the total bill for the claim?
[CUSTOMER][NEUTRAL] It's $750 even $75,750 even.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] OK, so for this um particular policy number that you gave, the policy is no longer active. It was effective from [PII], but there is an active policy that has been effective since [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] That policy number is 18502, I'm sorry, 1850627.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mm, hold on, I think that's the policy ID that uh being the claim has been submitted because the service date is [PII].
[AGENT][NEUTRAL] Right, I'm gonna check it. I'm just saying the policy number that you provided is not correct. Do you have the other policy number? I just want you to know if you have the active policy number. OK. So I'm looking under the active policy number for your claim. Hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, yeah, that's the active policy.
[AGENT][NEUTRAL] And what is the name of the provider's office on your claim?
[CUSTOMER][NEUTRAL] Uh, give me a moment please.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] The the specialty physicians.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, the reason I'm asking is because we have two claims that were processed on that.
[AGENT][NEUTRAL] We have 2 claims for that data service, but they're a different provider and a different total bill, so we don't have your claim on file.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. It's for public trust of
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Right, of the two claims that we process that have your date of service on it, it's a different provider and a different total bill. So we don't have a claim for $750 or with your provider.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, climb on. OK, what's the timely filing limit?
[AGENT][NEUTRAL] So there's no timely filing limit as long as the policy is active, you can um file the claim at any time.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Mhm. No timely filing limit to submit the claim, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, can I get the payer ID and the mailing address?
[AGENT][NEUTRAL] Sure. Our payer ID is 60801.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The mailing address, excuse me, the mailing address is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] The zip code is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, can you please provide the policy effective date and the termination date?
[AGENT][NEUTRAL] So, the current policy um has been active since [PII].
[AGENT][NEUTRAL] Hold on one moment, let me go back.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] This policy is still active?
[AGENT][NEUTRAL] And it's been effective since [PII]. Did you need the effective and termination date of the other policy again?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Uh, this is the active policy, right? That one is terminated.
[AGENT][NEUTRAL] Mhm. Yes, this one is active. The
[CUSTOMER][POSITIVE] OK, so this is enough. Thank you so much. Um, can I get the call reference number, please?
[AGENT][NEUTRAL] So there's no call reference number, but you can use my name in today's date. The first initial to my last name is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Mm, OK, and uh, thank you so much, and I do have two more clients. Can you please help me with that too?
[AGENT][NEUTRAL] Sure, is it the same member or different members?
[CUSTOMER][NEUTRAL] It's for a different number.
[AGENT][NEUTRAL] OK, hold on one moment, let me note this policy.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK, and the next member's policy number?
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK my please for this one.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] For the next one.
[CUSTOMER][NEUTRAL] Uh, and also the next policy, it's 02464420.
[AGENT][NEUTRAL] That was 02464420.
[CUSTOMER][POSITIVE] Yeah, it's correct.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] [PII] and for the date of birth [PII].
[AGENT][NEUTRAL] Thank you for that. And all the information provided is a verification of benefits, not a guarantee of payment. And may I have the date of service for the claim and the total bills?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh yes, so the date of service is [PII] and for the total charges of $269 even $269.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] And that was [PII]?
[CUSTOMER][NEUTRAL] Yeah, [PII].
[AGENT][NEUTRAL] OK, hold on one moment. So I'm actually showing there's no claims on file for [PII] from [PII].
[CUSTOMER][NEUTRAL] Uh-huh, for charges of 269, right?
[AGENT][NEUTRAL] There's no claim on file?
[CUSTOMER][NEUTRAL] Do you, uh
[CUSTOMER][NEUTRAL] OK do you have any other client other than this for for different charges and for the same date of service?
[CUSTOMER][NEGATIVE] Because I have one more day of service of sorry, one more total charges of $30 even.
[AGENT][NEUTRAL] Right, but there, but we don't have any claims on file for this date of service, so you can submit that for processing.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, we'll resubmit right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] Um, thank you so much, [PII]. Give me a moment. I'll.
[CUSTOMER][NEUTRAL] Different, I do have another client.
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, and the next member's policy number?
[CUSTOMER][NEUTRAL] Mm, give me a second please. I'm just.
[CUSTOMER][NEUTRAL] Mm, so the next number is 01749240 M as in Mike, L as in Lima, H.
[AGENT][NEUTRAL] Thank you for that. And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Mm, yeah, for the member name, [PII].
[CUSTOMER][NEUTRAL] And for the date of birth is [PII].
[AGENT][NEUTRAL] Thank you for that. And may I have the date of service for the claim and the total bills?
[CUSTOMER][NEUTRAL] Yeah, it's [PII].
[CUSTOMER][NEUTRAL] A charge of 356, 356.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK, so the policy number that you provided terminated on [PII]?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It was effective um on [PII], but there is an active policy on that policy number is 250.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 4898.
[CUSTOMER][NEUTRAL] Sorry, can you please repeat it again?
[AGENT][NEUTRAL] The active policy number is 2504898.
[AGENT][NEUTRAL] That's what's active now as of [PII]. Um, so I'm still gonna look on the other claim to get your, um, to see if your claim is there.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, hold on one moment.
[AGENT][NEUTRAL] And that was [PII]?
[CUSTOMER][NEUTRAL] [PII], yeah.
[AGENT][NEUTRAL] OK, let me see if it's on the other policy. So I looked on the 1,749,240 policy number that you gave, but there's no claim on file. And the other one, let me think.
[AGENT][NEUTRAL] The one that's active now though wouldn't be, it wasn't effective on your data service, only this one was. So you can still file that claim as well.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] The policy number I gave you is inactive, right?
[AGENT][NEUTRAL] Right, the policy number that you gave me was active on the date of service, it's not active now.
[CUSTOMER][NEUTRAL] Mhm. OK.
[CUSTOMER][NEUTRAL] Can you please provide me the
[CUSTOMER][NEUTRAL] What is the effective and termination of.
[CUSTOMER][NEUTRAL] Of the ID which I've given you.
[AGENT][NEUTRAL] Yes, hold on, let me.
[AGENT][NEUTRAL] So the policy number that you provided was effective from [PII]?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mm and termination on [PII], OK.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] [PII], right?
[AGENT][NEUTRAL] No, [PII].
[CUSTOMER][NEUTRAL] Mhm first. OK.
[CUSTOMER][POSITIVE] [PII]. Thank you so much, [PII]
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] can they submit this claim.
[CUSTOMER][NEUTRAL] To the same I, right?
[AGENT][POSITIVE] I'm I'm sorry?
[CUSTOMER][NEUTRAL] We can resubmit the claim to the same payer ID, right? That one you given for the first account.
[AGENT][NEUTRAL] Um, let me make sure they have the same, yes, that's fine.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No claim on file.
[CUSTOMER][NEUTRAL] Uh, can you please provide me the policy effective date of the last claim, like last member ID given which is uh.
[CUSTOMER][NEUTRAL] The previous one before this.
[AGENT][NEUTRAL] I'm sorry, what's the question? The previous claim that we worked on, what's the policy number for that one?
[CUSTOMER][NEUTRAL] Oh, give me more.
[AGENT][NEUTRAL] The effective date?
[CUSTOMER][NEUTRAL] Mhm, yeah.
[AGENT][NEUTRAL] No, I'm asking, I'm trying to clarify your question. What's the question that you're asking?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] The first one before this one I've given you one member ID right?
[AGENT][NEUTRAL] Well, we went over 3. I'm just trying to understand which one you're asking for the effective date for.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] That is it 174?
[CUSTOMER][NEUTRAL] Hold on, I'll provide you the member ID.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, give me a moment, please.
[CUSTOMER][NEUTRAL] Uh, it's 02464420.
[AGENT][NEUTRAL] Oh, that's the last member. OK, hold on one second.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, so for 64,420, there is no termination date. It's been effective since [PII].
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] [PII] still effective, OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Thank you so much.
[AGENT][POSITIVE] You're welcome. Was there anything else I could assist you with today?
[CUSTOMER][POSITIVE] Mm, no, [PII], thanks for asking.
[AGENT][POSITIVE] You're welcome, [PII]. Well, thanks for calling APL. I hope you have a great day.
[CUSTOMER][POSITIVE] Great day bye bye.
[AGENT][POSITIVE] Thank you bye