AccountId: 011433970860
ContactId: bfb7f37c-5fe3-4ce1-b0fa-8dee01166f51
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 748909 ms
Total Talk Time (AGENT): 249566 ms
Total Talk Time (CUSTOMER): 272205 ms
Interruptions: 2
Overall Sentiment: AGENT=0.4, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/21/bfb7f37c-5fe3-4ce1-b0fa-8dee01166f51_20250521T19:46_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey [PII], I'm [PII] calling from provider's office to check on claim status.
[AGENT][NEUTRAL] OK, [PII], you're needing claim status, is that correct?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] Yes, I can help you with that, [PII] and what is your callback number?
[CUSTOMER][NEUTRAL] Yeah, the call back number is [PII].
[AGENT][NEUTRAL] Thank you. And how many claims, [PII], do you have to check status on?
[CUSTOMER][NEUTRAL] 02 claims.
[AGENT][NEUTRAL] Are they for the same patient or different patients?
[CUSTOMER][NEUTRAL] Same patient.
[AGENT][NEUTRAL] OK, so it's 1 patient and 2 dates of service. Is that correct?
[CUSTOMER][NEUTRAL] Um, maybe the date of service is same but different bill amount you can say that.
[AGENT][NEUTRAL] OK, alright, [PII], so I can help you with this and any information that I provide for you today will be a verification of benefits and not a guarantee of payment. What is the policy number for your patient?
[CUSTOMER][NEUTRAL] Um, uh, just one moment, let me pull that for you once again.
[CUSTOMER][POSITIVE] Thank you so much.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] Um, so how would you, how was your day going?
[AGENT][NEUTRAL] It has been very busy. How about yours?
[CUSTOMER][NEUTRAL] Yeah, busy as well.
[AGENT][NEUTRAL] Mhm mhm.
[CUSTOMER][NEUTRAL] Just trying to get through the day, yeah.
[AGENT][NEUTRAL] Right, me too.
[CUSTOMER][NEUTRAL] Yeah, just, um, OK.
[CUSTOMER][NEGATIVE] Just one moment. I'm my system is very slow.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you so much for your patience.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] Yeah, OK. Um,
[CUSTOMER][NEUTRAL] Why is it taking so much time? Sorry for that.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, um,
[CUSTOMER][NEUTRAL] So you want uh the uh
[AGENT][NEUTRAL] Policy number?
[CUSTOMER][NEUTRAL] Policy number, sorry for that. Yeah. Policy number is 01611717 M as in Mike L as in Lima 8.
[AGENT][NEUTRAL] OK, thank you. One moment while I load the information.
[AGENT][NEUTRAL] And it again, [PII], any information provided will be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Patient's name is uh [PII].
[CUSTOMER][NEUTRAL] And date of birth is [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And what is the date of service, the first date of service and total bill amount?
[CUSTOMER][NEUTRAL] Yeah, the service is um [PII]. bill amount is $1500 even.
[AGENT][NEUTRAL] 1500. Is that correct?
[CUSTOMER][NEUTRAL] Um, yeah.
[CUSTOMER][NEUTRAL] And may I get your name as [PII] and your initials will be?
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And my name and today's date, uh-huh, will also be your call reference number.
[CUSTOMER][POSITIVE] Thank you so much, [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so for date of service [PII] there is no claim on file for this filled amount.
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And when you do submit the claim, [PII], we will have to have a copy of the primary insurance company's explanation of benefits along with the claim for review.
[CUSTOMER][NEUTRAL] OK. Um, do you have a, can you give me the policy effective date and term date?
[AGENT][NEUTRAL] The effective date is 1.
[CUSTOMER][NEUTRAL] The family family.
[AGENT][NEUTRAL] So the policy is active with an effective date of [PII].
[AGENT][NEGATIVE] And there is no timely filing limit.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Of [PII].
[CUSTOMER][NEUTRAL] [PII], right? And to no termination date?
[AGENT][POSITIVE] That is correct.
[AGENT][NEGATIVE] And there is no timely filing limit.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Uh, can you also give me the correct payer ID, uh, uh, and the mailing address in case, uh, it will be a different payer ID or mailing address. I can check that for you.
[AGENT][NEUTRAL] Payer ID is 60801.
[AGENT][NEUTRAL] The claims PO box.
[CUSTOMER][NEUTRAL] 60
[CUSTOMER][NEUTRAL] 60801.
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] The mailing address for claims is [PII].
[CUSTOMER][NEUTRAL] Yeah, mailing.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] The zip code
[CUSTOMER][NEUTRAL] Can you spell that, please?
[AGENT][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] The next door is [PII]
[AGENT][NEUTRAL] The state is [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The zip code is [PII].
[CUSTOMER][NEUTRAL] OK. That will be [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] No, it is [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] No, actually I was asking for the initials for [PII] like we write something like for [PII] that is [PII] So. OK, got it, yeah.
[AGENT][NEUTRAL] Yes, OK.
[AGENT][NEUTRAL] It's [PII]
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, the zip code will be.
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] 895-0731248950
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] Um, OK, just one moment, I will check that for you right now.
[CUSTOMER][NEUTRAL] Pay ID is 60801.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] 248,950 [PII].
[CUSTOMER][NEUTRAL] 8800.
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] Again, the PO box is [PII].
[CUSTOMER][NEUTRAL] OK. [PII].
[AGENT][NEUTRAL] OK, let's do it again because I think we're getting confused. The [PII] number is [PII].
[CUSTOMER][NEUTRAL] Oh yeah.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] The zip code is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, um, just one moment. I have, uh, let me go to the another claim and check the same if it is billed to the incorrect. I think it is billed to the incorrect payer that is why you have no claim on file.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Maybe. Just one moment, let me double check again.
[AGENT][NEUTRAL] Maybe. OK. Sure.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Oh,
[CUSTOMER][NEUTRAL] Just one moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] One moment, please. Thank you so much.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Um, yeah, I think it was sent to the different pay ID mailing address. What I'm gonna do is I'm gonna build to the correct payer ID given by you, that is.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 60801 and uh I'm going to send you uh.
[CUSTOMER][NEUTRAL] New claim, sorry, the current claim with the current payer ID and email address, OK.
[AGENT][NEUTRAL] And also the primary insurance company's explanation of benefits.
[CUSTOMER][NEUTRAL] Um, the primary insurance company, you'll be OK.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Mhm. Got that.
[AGENT][NEUTRAL] And then once the claim has been processed by APL Rosy, we do have a portal that you should also be able to check claim status in.
[CUSTOMER][NEUTRAL] OK, got it.
[AGENT][NEUTRAL] And our website for the portal is.
[CUSTOMER][NEUTRAL] And does it need?
[AGENT][POSITIVE] Yes, it's secured.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]. Again, that is secured. [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. Mhm.
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] Um, you give the mailing address as PO Box, just double checking.
[CUSTOMER][NEUTRAL] [PII], right?
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Um, uh, but in the insurance card, the, uh, the, it is different, I guess.
[CUSTOMER][NEUTRAL] Can you also check for that?
[AGENT][NEUTRAL] The payer ID on the member's APL ID card?
[CUSTOMER][NEUTRAL] No, the mailing address.
[AGENT][NEUTRAL] It may be an old PO box.
[AGENT][NEUTRAL] What's the, is it a PO Box 925?
[CUSTOMER][NEUTRAL] Yeah, PO box.
[CUSTOMER][POSITIVE] Yeah, correct.
[AGENT][NEUTRAL] That's an old address.
[AGENT][NEGATIVE] That's no longer valid.
[CUSTOMER][POSITIVE] OK, got you, got you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And there is no terminal filing, right?
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Got it.
[CUSTOMER][NEUTRAL] OK, I'm gonna send you the primary UB as well as I'll pay. I'll like submit the correct claim with you correct pay ID.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Well, is there anything else, [PII] I could help you with?
[CUSTOMER][POSITIVE] Yeah, thank you so much.
[CUSTOMER][POSITIVE] No, thank you so much. You have a great day.
[AGENT][POSITIVE] Well, well, I hope you have a great day too, and thank you again for calling APL.
[CUSTOMER][POSITIVE] Yep, take care. Bye-bye.
[AGENT][NEUTRAL] Uh, you too. Bye bye.
[CUSTOMER][NEUTRAL] Bye.