AccountId: 011433970860
ContactId: c584b593-fc3c-429b-ab11-8d43d4e52f09
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 445850 ms
Total Talk Time (AGENT): 131737 ms
Total Talk Time (CUSTOMER): 157861 ms
Interruptions: 0
Overall Sentiment: AGENT=1.2, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/04/c584b593-fc3c-429b-ab11-8d43d4e52f09_20250204T21:39_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Oh hi [PII]. My name is [PII], and I'm calling from the provider office with regards to our claim status. And how are you doing today?
[AGENT][POSITIVE] I'm good, [PII]. Thank you so much. I'm happy to check a claim. What's the patient's policy number?
[CUSTOMER][NEUTRAL] Uh, sure. The policy number is
[CUSTOMER][NEUTRAL] It is 02370305 M as in Mike, L as in Lima, 8.
[AGENT][POSITIVE] All right, thank you so much. One moment, let me pull this up.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] May I please have the patient name and date of birth?
[CUSTOMER][NEUTRAL] Uh, sure. Uh, the name is?
[CUSTOMER][NEUTRAL] It is [PII] and the date of birth is [PII].
[AGENT][POSITIVE] Thank you. Data of service?
[CUSTOMER][NEUTRAL] Uh, data service is [PII]. Uh it has a total charge of $517 even that is 517.
[AGENT][POSITIVE] Thank you so much. Let me take a look here, one moment.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] Alright, date of service [PII]. I'm not showing any claims on file.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK. Uh, mm, uh, could you tell me, uh, the claim's mailing address and the payer ID?
[AGENT][NEUTRAL] Claims mailing address is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And that's in [PII].
[AGENT][NEUTRAL] Zip code is [PII].
[CUSTOMER][NEUTRAL] But.
[CUSTOMER][NEUTRAL] And could you tell me the payer ID?
[AGENT][NEUTRAL] Payer ID is 60801.
[CUSTOMER][NEUTRAL] OK. And could you tell me the claims, uh, timely filing limit?
[AGENT][NEGATIVE] No timely filing.
[CUSTOMER][NEUTRAL] OK. And uh lastly, could you provide me the uh coverage affect you and the term date?
[AGENT][NEUTRAL] Uh, yeah, absolutely. Let's see. Policy, the effective date is [PII]. There is no term date. Patient is still active.
[CUSTOMER][NEUTRAL] Uh, sure. Uh, thank you for that, sir. And, uh, [PII], I have one other claim again. It's again a new claim submission. Will you be able to help me with that? Uh, it's uh in different number.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah, absolutely. What is the member's policy whenever you're ready?
[CUSTOMER][NEUTRAL] Uh, sure, just give me one moment. I just have to open the page.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. So, uh, the member ID is, it is 10605184 M as in Mike, L as in Lima, 7.
[AGENT][POSITIVE] Thank you so much. And what is the patient name and date of birth?
[CUSTOMER][NEUTRAL] Uh, patient name is uh [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] And the policy number just to confirm was 106.
[AGENT][NEUTRAL] 05184.
[CUSTOMER][NEUTRAL] Oh yes, that's right. And after that it is M as in Mike, L as in Lima, and then the number 7.
[AGENT][NEUTRAL] Alright, one moment, let's see.
[AGENT][NEUTRAL] It doesn't come up with that patient's name on it. Nothing comes up. Let me take a search by their name. First name is [PII], last name is [PII].
[CUSTOMER][NEUTRAL] Yes, right. Uh the [PII] actually, [PII]
[AGENT][NEUTRAL] OK. One moment.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And what was [PII]'s date of birth again, please?
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] Alright, thank you for that. What is the date of service?
[CUSTOMER][NEUTRAL] It is [PII] and it has a total charge of $522 even.
[AGENT][NEUTRAL] Alright, one moment, [PII].
[CUSTOMER][NEUTRAL] that
[CUSTOMER][NEUTRAL] [PII], yes, [PII] and total charge $522 even by total.
[AGENT][NEUTRAL] So not showing any claims on file for [PII] for [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] All right. Sure. Thank you for the confirmation, right? And could you tell me the coverage effective and term date on this?
[AGENT][NEUTRAL] Effective date is [PII].
[AGENT][NEUTRAL] Policy is still active, no term date.
[CUSTOMER][NEUTRAL] OK. And the best information what you gave in the previous one rest remains the same, but the claim mailing address, payer ID and everything.
[AGENT][POSITIVE] Mhm. Correct.
[CUSTOMER][NEUTRAL] OK. And, sir, I'm really sorry. Just one confirmation uh regarding the mailing address. Uh, uh, uh, the city is [PII] and the state is [PII], yeah.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] All right. OK. Uh thank you for that, you know. I believe we have submitted to an inact address, and I was just verifying the address and the payer ID. I believe what I see here is different. So thank you for the information, right? We will, uh, review and submit uh to the correct uh information then. And, uh, [PII], is there a reference number for the call?
[AGENT][NEUTRAL] Absolutely, [PII]. Call references my name with my last initial than today's date. My name again is [PII], which is [PII] Last initial to my name is [PII].
[CUSTOMER][POSITIVE] Oh, sure. Thank you, sir, and you have a great rest of your day, all right? Bye-bye, take care.
[AGENT][NEUTRAL] You as well. Bye-bye.