AccountId: 011433970860
ContactId: c2de028f-399b-43f3-adae-284bc587b64d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 340380 ms
Total Talk Time (AGENT): 120377 ms
Total Talk Time (CUSTOMER): 106498 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/21/c2de028f-399b-43f3-adae-284bc587b64d_20250321T18:09_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from provider's office. I'm checking on general claim status.
[AGENT][POSITIVE] OK, [PII], I'm happy to check on a claim status for you today. What's the patient's policy number?
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] And members ID number would be 01.
[CUSTOMER][NEUTRAL] 708214. M as in Mary, L as in Lima, 8.
[AGENT][NEUTRAL] Do you have a good call back number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] And I'm sorry, I missed your name. Can you please spell your name for me?
[AGENT][NEUTRAL] My name is spelled [PII].
[CUSTOMER][NEUTRAL] I it's from the [PII].
[AGENT][NEUTRAL] Mhm. What's the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] And the patient's name will be [PII] and date of birth, [PII].
[AGENT][NEUTRAL] OK, and what's the data service that you're checking on?
[CUSTOMER][NEUTRAL] And the date of service will be [PII].
[CUSTOMER][NEUTRAL] With the billed amount of $320 even.
[AGENT][NEUTRAL] All right, one moment.
[AGENT][NEUTRAL] All right, [PII], thank you for your patience and waiting on that. So I'm not showing any claims on file for the billed amount of $328 for [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, the lima split into two.
[CUSTOMER][NEUTRAL] the 11 is $280 a month and one is $48 a month.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So.
[AGENT][NEUTRAL] We did receive a claim for a billed amount of $280. That claim was received on [PII].
[AGENT][NEUTRAL] The claim was denied. It looks like uh services were not covered when performed in a doctor's office or clinic.
[CUSTOMER][NEUTRAL] OK. Only one claim was received for $280.
[AGENT][NEUTRAL] It was received [PII].
[CUSTOMER][NEUTRAL] Yes, and what about the amount of $48 a month?
[AGENT][NEUTRAL] I don't show anything on file for that.
[CUSTOMER][NEUTRAL] OK, can I please submit the claim for this one?
[AGENT][NEUTRAL] I'm sorry, can
[CUSTOMER][NEUTRAL] Because the bill amount is 320.
[CUSTOMER][NEUTRAL] Can I, the reason with the claim for this one cause the bill amount is $328 even.
[AGENT][NEUTRAL] You
[AGENT][NEUTRAL] You can resubmit a corrected claim, yes.
[CUSTOMER][POSITIVE] Yeah, OK, thank you so much.
[CUSTOMER][NEUTRAL] And can I get the mailing address for this one?
[AGENT][NEUTRAL] Mailing address would be [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And that's in [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The zip code is [PII].
[CUSTOMER][NEUTRAL] [PII]. OK. May I know the effective date?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Effective date is [PII]. Patient is still active.
[CUSTOMER][POSITIVE] OK, thank you so much. And there is any fax number?
[AGENT][NEUTRAL] Fax number is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII] 3.
[CUSTOMER][POSITIVE] OK, thank you so much for this, sir. And may I know the payer ID?
[AGENT][NEUTRAL] 608.
[AGENT][NEUTRAL] 01.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 60801. OK. Can I know the time difference?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEGATIVE] No timely filing limit.
[CUSTOMER][NEGATIVE] There's no time for for in-network provider on.
[AGENT][POSITIVE] Correct.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you so much for this information and can I get the call reference number?
[AGENT][NEUTRAL] Call reference is my name with my last initial in today's date. My name again is [PII], that's [PII] and my last initial is [PII].
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][POSITIVE] Thank you so much for this information.
[AGENT][POSITIVE] You're welcome. Have a good day.
[CUSTOMER][POSITIVE] You too. Take care. Bye-bye.
[AGENT][NEUTRAL] Mhm.