AccountId: 011433970860
ContactId: c1e1fb64-a30e-442c-bc75-528c79ab7e63
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 323640 ms
Total Talk Time (AGENT): 105799 ms
Total Talk Time (CUSTOMER): 144178 ms
Interruptions: 4
Overall Sentiment: AGENT=0, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/21/c1e1fb64-a30e-442c-bc75-528c79ab7e63_20250521T18:30_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey, you said your name is [PII], right?
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] My name is [PII]. Yes, my name is [PII]. Um it's spelled [PII] Last initial is [PII].
[CUSTOMER][NEUTRAL] Yeah. Hey, [PII]. My name is [PII]. I'm calling from provider's office regarding a medical claim. Can you please help me with that? And this call is recorded for quality and training purposes.
[AGENT][NEUTRAL] Sure, [PII]. I can assist you with claim status. Um, first, could I get a good callback number just in case we're disconnected?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah, it's [PII].
[AGENT][NEUTRAL] Thank you. Now I need the policy number, please.
[CUSTOMER][NEUTRAL] Policy number is 024.
[CUSTOMER][NEUTRAL] 55,070.
[AGENT][NEUTRAL] And please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Patient's name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you. Now, I need the date of service and bill charges on the claim.
[CUSTOMER][NEUTRAL] Data services [PII]. Total bill amount is 161.
[AGENT][NEUTRAL] You said that was [PII]?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, I'm not showing that claim on file.
[CUSTOMER][NEUTRAL] OK. Got it. So, uh, uh, may I know
[CUSTOMER][NEUTRAL] Uh, what is the, do you know, can you please tell me the member's eligibility that is active or not on the date of service?
[AGENT][NEUTRAL] Um, yes, and just let me advise you that verification of coverage does not guarantee payment of claims. The effective date on this policy was [PII] and the policy is still active. So yes, the patient was active on the date of service.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] [PII]. OK, got it. So, uh, may I know you are the primary or a secondary for a member according to the COB?
[AGENT][NEUTRAL] We're, we're the, yes, we're the secondary.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And who is the primary, ma'am, uh, primary insurance?
[AGENT][NEUTRAL] We don't keep that information on file. We don't keep that information on file.
[CUSTOMER][NEUTRAL] OK. You don't give that information.
[CUSTOMER][NEUTRAL] OK, got it. Can you please provide me
[CUSTOMER][NEUTRAL] Your
[CUSTOMER][NEUTRAL] Per ID.
[AGENT][NEUTRAL] Yes, our payer ID is 60801.
[CUSTOMER][NEUTRAL] What's the mailing address?
[AGENT][NEUTRAL] The mailing address is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] Um, [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And the zip code is [PII].
[CUSTOMER][NEUTRAL] OK, got it.
[CUSTOMER][NEUTRAL] And what's the timely filing limit?
[AGENT][NEUTRAL] There's no timely filing limit?
[CUSTOMER][NEUTRAL] Uh, so there's no time filing limit to submit the claim.
[AGENT][NEGATIVE] Right, there's no timely filing limit.
[CUSTOMER][NEUTRAL] So we can submit that a claim whenever we want.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Yes, sir. Is there anything else I can assist you with?
[CUSTOMER][NEUTRAL] Yeah, OK.
[CUSTOMER][NEUTRAL] Wait a moment, I'm checking.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you so much. Can I have a call reference number?
[AGENT][NEUTRAL] Um, yes, sir. For the reference number, you can use my name in today's date.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. So, uh, uh, did you provide the fax also to submit the claim? Do you accept the fax?
[AGENT][NEUTRAL] Yes, there is a fax number. Um, our fax number is
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And please attention it to the claims department.
[CUSTOMER][NEUTRAL] 9
[CUSTOMER][NEUTRAL] 94233.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][POSITIVE] OK. Thank you so much.
[CUSTOMER][POSITIVE] [PII], have a nice day. Bye-bye.
[AGENT][POSITIVE] OK, thank you, um, [PII] for calling APL. You have a great day. Mm bye.
[CUSTOMER][NEUTRAL] You, you too.