AccountId: 011433970860
ContactId: c21fa731-e897-49c0-8a93-b272121d4764
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 161580 ms
Total Talk Time (AGENT): 75361 ms
Total Talk Time (CUSTOMER): 61575 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/15/c21fa731-e897-49c0-8a93-b272121d4764_20250115T18:28_UTC.wav
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[AGENT][POSITIVE] Afternoon, thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Yeah, hi, I'm [PII] calling from provider's office to check on the claim status. Can you please spell your name for the documentation purpose?
[AGENT][NEUTRAL] Sure. That's [PII]. Last initial is [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And I need a callback number just in case we get disconnected, Mr. [PII]. You're welcome.
[CUSTOMER][POSITIVE] Thanks for that.
[CUSTOMER][NEUTRAL] Yeah, it's [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Yeah, it's 02284511.
[AGENT][NEUTRAL] OK, thank you. One moment.
[AGENT][NEUTRAL] And may I have the name and date of birth of the patient, Mr. [PII]?
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] [PII]. And the date of birth is [PII].
[AGENT][NEUTRAL] Thank you. And you say you need claim status. What is the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] Yeah, actually, I need the information regarding the eligibility of the per member. So, can I get that?
[AGENT][NEUTRAL] Eligibility, OK, sure.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yes, um, this particular policy was effective [PII] and it terminated [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Got it. So, can I know what is the time of filing limit to file a claim?
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] We don't have timely filing limits for claim submission.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Got it. So can I confirm the mailing address? Can you please tell me that?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Sure. Mailing address is [PII] [PII], and the zip code is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK. Can I get the payer ID too?
[AGENT][NEUTRAL] Uh payer ID is 60801. Again, that's 60801. Now we need to claim either fax or mail because we need the explanation of benefits from the primary insurance attached to it.
[CUSTOMER][NEUTRAL] Mm, OK, got it.
[CUSTOMER][NEUTRAL] Can I have the call reference number?
[AGENT][NEUTRAL] We don't have reference numbers, you can use my name in today's date if you will.
[CUSTOMER][POSITIVE] OK. Thank you. Got it. That's it for today. Thank you for your assistance and your cooperation. I appreciate that. Have a great day.
[AGENT][POSITIVE] You as well, Mr. [PII]. Thank you for calling APL. Bye-bye.