AccountId: 011433970860
ContactId: bede9b2c-a527-493e-b00b-c582eb46bcd2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 243660 ms
Total Talk Time (AGENT): 128358 ms
Total Talk Time (CUSTOMER): 74993 ms
Interruptions: 3
Overall Sentiment: AGENT=0.8, CUSTOMER=1.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/26/bede9b2c-a527-493e-b00b-c582eb46bcd2_20250226T13:20_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Good morning, [PII]. My name is [PII]. Last initial A calling with McCloud Regional Medical Center, uh, checking the status on the claim.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, [PII], you have one claim to check status on, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Yes ma'am, I can help you with that. And [PII], what is a good callback number for you, please?
[CUSTOMER][NEUTRAL] [PII] and that's a direct line.
[AGENT][NEUTRAL] Thank you and the member's policy number please, [PII].
[CUSTOMER][NEUTRAL] 02260490
[AGENT][NEUTRAL] Thank you. One moment while I get the information pulled up for the number, please.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] OK, and [PII], any information that I do provide for you today would be a verification of benefits and not a guarantee of payment. What is your patient's name, please, and date of birth?
[CUSTOMER][NEUTRAL] [PII], uh, [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And the date of service and total bill amount for her place.
[CUSTOMER][NEUTRAL] That would be for [PII] for $3,909.83.
[AGENT][NEUTRAL] I'm so sorry, can you give me the billed amount again, please?
[CUSTOMER][NEUTRAL] $3,909.83.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] And you said [PII].
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, we do not have a claim on file for her for that data service.
[CUSTOMER][NEUTRAL] OK, on, [PII]. Do you show her active for that data service?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes, ma'am. This policy went into effect [PII] with no term date.
[AGENT][NEUTRAL] Now when you do send the claim to us, um.
[AGENT][NEUTRAL] [PII], we will also have to have a copy of her primary insurance company's explanation of benefits as well.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And then once we have processed our claim, we do have a portal that you should be able to check our claim status in and have access to our EMC. You already have our portal website.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh, I do. I'm just waiting. I, I'm not a, my company doesn't let me create it ourselves. We have to wait for somebody in our management office to do it for us, so I'm just waiting on that. Uh, can you just verify the mailing address where it's supposed to be submitted to?
[AGENT][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] Uh, OK.
[AGENT][NEUTRAL] Oh, OK. OK.
[AGENT][NEUTRAL] Sure. The uh claims mailing address is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the zip code is [PII].
[CUSTOMER][NEUTRAL] Do you have a, do you do electronic as well? Do you have a payer ID?
[AGENT][NEUTRAL] Yes, it is 60801.
[CUSTOMER][NEUTRAL] OK. And what's the timely, what's the timely filing limit?
[AGENT][NEUTRAL] And again, there is.
[AGENT][NEGATIVE] There is no timely filing limit.
[CUSTOMER][POSITIVE] Oh, that's beautiful. No. OK, perfect. And can I just get a reference number?
[AGENT][NEUTRAL] Uh, you would use my name along with today's date and if you need the first initial to my last name, it's [PII].
[CUSTOMER][POSITIVE] Perfect. Thank you so much and you have a wonderful day.
[AGENT][POSITIVE] I hope you do too, [PII], and if that's all I can help you with, thank you again for calling APL.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Bye-bye.
[CUSTOMER][NEUTRAL] Bye bye.