AccountId: 011433970860
ContactId: bd2be4f5-f729-4f84-a410-eb303074484c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 272459 ms
Total Talk Time (AGENT): 113673 ms
Total Talk Time (CUSTOMER): 103766 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/16/bd2be4f5-f729-4f84-a410-eb303074484c_20250116T20:18_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Um, yes, I'm calling to check claim status for a patient.
[AGENT][NEUTRAL] OK, sure. I can assist you with claim status, and may I have your name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Yes, that is.
[CUSTOMER][NEUTRAL] D as in dog 437301-97.
[AGENT][NEUTRAL] Do you see a policy certificate number? It's gonna start with the 0 followed by 7 digits.
[CUSTOMER][NEUTRAL] Um, one moment, let me pull the insurance card.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Oh OK so you need the policy certificate number.
[AGENT][NEUTRAL] Yes. Mhm.
[CUSTOMER][NEUTRAL] OK, I have that as 024.
[CUSTOMER][NEUTRAL] 66876.
[AGENT][NEUTRAL] All right. And may I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][POSITIVE] Perfect. And may I have the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] And the date of service is [PII] and the bill amount is $238.02.
[AGENT][NEUTRAL] All right, thank you. Let me see if I can find this claim. For future, you can check claim status online through our website at [PII] and that's just optional.
[AGENT][NEUTRAL] Um
[AGENT][NEUTRAL] All right, we do not have a claim for [PII] for December.
[CUSTOMER][NEUTRAL] OK, and let me just be sure that we have this going to the correct claim's address [PII].
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Um, bear with me
[AGENT][NEUTRAL] OK. Uh, and you said [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes, that is the correct address.
[CUSTOMER][NEUTRAL] OK, so we're showing that we mailed this claim [PII], so it's had plenty of time to make it there. Um, do you all receive, uh, claims by fax?
[AGENT][NEUTRAL] No, it goes to IMA before it comes to us. Um, they do their pricing before they send it to us, and, um, they only have a payer ID and the mailing address.
[CUSTOMER][NEUTRAL] OK, and to clarify as well since I gave you the medical ID number from the card instead of the policy number, would the incorrect number listed on the claim have caused it to reject and not been entered into the system by chance?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] No, no, uh, that the number is IMA. So if you use the D number or if you use our policy number, they should be able to find it. And once they do the repricing they'll go ahead and send it to us, but I'm not sure if they got it or not, but it doesn't look like it if we did not receive it.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and what is the timely filing deadline?
[AGENT][NEUTRAL] Yeah.
[AGENT][NEGATIVE] We don't have timely filing limits.
[CUSTOMER][NEUTRAL] OK, that's, that's good to know. OK, so I will resubmit this claim and then I will call back in a few weeks to see um if you get the new claim, I guess, um, and may I get your name and a call reference number?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] My name is [PII]. That's [PII]. Last initial is [PII], and we don't have reference numbers. You can use my name in today's date if you would like.
[CUSTOMER][POSITIVE] OK, alright, that's all I needed thank you so much I appreciate your time today.
[AGENT][POSITIVE] OK. You're welcome and thank you for calling APL. Have a good afternoon, Ms. [PII].
[CUSTOMER][NEUTRAL] You too bye bye.