AccountId: 011433970860
ContactId: c7a1a135-f3af-4357-98d7-6632ae9554f3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1175859 ms
Total Talk Time (AGENT): 303464 ms
Total Talk Time (CUSTOMER): 297070 ms
Interruptions: 3
Overall Sentiment: AGENT=0.1, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/15/c7a1a135-f3af-4357-98d7-6632ae9554f3_20250515T14:23_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Yeah. I need the claim information. Can you assist me with that?
[AGENT][NEUTRAL] OK, sure. I can assist you with claims. May I have your name?
[CUSTOMER][NEUTRAL] Yeah, my name is [PII] and the last in is [PII]. Can you spell your name, please?
[AGENT][NEUTRAL] That's [PII].
[AGENT][NEUTRAL] And may I have a callback number just in case we get disconnected, Miss [PII]?
[CUSTOMER][NEUTRAL] Yes, it's [PII] with the extension [PII].
[AGENT][NEUTRAL] OK, thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] The member's policy ID is 02481583.
[AGENT][NEUTRAL] Thank you. May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Yes, the name is.
[CUSTOMER][NEUTRAL] The first name is [PII]. And the date of birth is [PII].
[AGENT][NEUTRAL] All right. And what is the date of service and the amount of the claim, Miss?
[CUSTOMER][NEUTRAL] Yeah, it's 531-2024. The charge amount is $1,778 even.
[AGENT][NEUTRAL] OK, [PII], correct?
[CUSTOMER][NEUTRAL] [PII] of, yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, let me see if I can find this claim and for future you can check claim status online through our website at [PII] and that's just optional.
[AGENT][NEUTRAL] And bear with me, let me see.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] OK, let me look at this claim and see if this is your claim. One moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] yeah.
[AGENT][NEUTRAL] Uh, do you have a procedure code for me, Miss [PII]?
[CUSTOMER][NEUTRAL] You ask for procedure code?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yeah, it is 43239.
[AGENT][NEUTRAL] I'm still searching for your claim, OK?
[AGENT][NEUTRAL] You said the total charge was $1,778?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Are you, can you check with the uh $55?
[AGENT][NEUTRAL] $55.
[AGENT][NEUTRAL] I don't have one for $55.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] It's $17778 it's uh yeah.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] No, I don't see that claim on file. I don't have anything for that amount for $1,778.
[CUSTOMER][NEUTRAL] Can you check, uh, like we will the claim on [PII]. Can you check with the date?
[AGENT][NEUTRAL] And then
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] We have several claims around that time, but I don't see that amount.
[CUSTOMER][POSITIVE] A woman bliss.
[AGENT][NEUTRAL] Hm
[CUSTOMER][NEUTRAL] I do not have even claim number to say it. Uh, I'm just checking.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Then can I get the timely filing to submit the claim?
[AGENT][NEGATIVE] We don't have timely filing limits.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And may I know the patient effective dates?
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] The effective date is [PII].
[AGENT][NEUTRAL] And it was terminated [PII].
[CUSTOMER][NEUTRAL] May I know is uh APL is the primary or any other insurance is the primary?
[AGENT][NEUTRAL] No, we are the secondary policy.
[CUSTOMER][NEUTRAL] Uh, OK. And may I know how we can send the claim, uh, mailing address or payer ID?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] You can fax it or mail it. If you're gonna fax it, the fax number is [PII].
[AGENT][NEUTRAL] If you're gonna mail it, the mailing address is [PII].
[AGENT][NEUTRAL] [PII]. The zip code is [PII].
[CUSTOMER][NEUTRAL] Thank you. Do you have any payer ID?
[AGENT][NEUTRAL] Um, you, we do have a payer ID. Now this type of product is a secondary. We need the primary EOB attached to it.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] If you can send the it will be attached electronically, you can send it to 601.
[AGENT][NEUTRAL] I'm sorry, 608-01.
[CUSTOMER][NEUTRAL] 608.
[CUSTOMER][NEUTRAL] 01.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] A moment please. I'm just checking whether I take all the details correctly.
[AGENT][NEUTRAL] OK, that's true.
[CUSTOMER][POSITIVE] Yeah, thank you.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, I got the required information for this claim. And I do have another, another claim for the same patient. Can you verify that?
[AGENT][NEUTRAL] What's the date of service?
[CUSTOMER][NEUTRAL] Yeah, state of service is on.
[CUSTOMER][NEUTRAL] A moment. I just, I need to open it.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, data service is on same [PII].
[AGENT][NEUTRAL] What's the, uh, the amount?
[CUSTOMER][NEUTRAL] It's a 177.
[CUSTOMER][NEUTRAL] $8 even.
[AGENT][NEUTRAL] We don't have any claims for that amount.
[CUSTOMER][NEUTRAL] It's 1000, sorry, 17.
[CUSTOMER][NEUTRAL] Yeah, as you said before.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] A moment. I need to check.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] And I do have another claim for the different patient. Can you verify that?
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Actually, uh,
[CUSTOMER][NEUTRAL] Sorry, sorry, sorry. Uh sorry for this inconvenience.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, I said that I do have another claim for the same patient, right? The, the bill amount is not set 1000, it's uh different. Can you check that one second?
[AGENT][NEUTRAL] What is the amount?
[CUSTOMER][NEUTRAL] Yeah, it's 396 dollars.75 cents.
[AGENT][NEUTRAL] 396.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yeah, I can't have that one either. Bear with me. What is the procedure code on that one?
[CUSTOMER][NEUTRAL] 0073 1
[AGENT][NEUTRAL] You said 00731?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And that's still for [PII], correct?
[CUSTOMER][POSITIVE] Yes, state of service.
[AGENT][NEUTRAL] Mhm. Yeah, that claim is not on file.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Can you check for the another claim? Let me see whether I do have different.
[AGENT][NEUTRAL] How many more claims do you have, Miss [PII]?
[CUSTOMER][NEUTRAL] Bill amount
[CUSTOMER][NEUTRAL] Uh, for the same patient, I do have 3 claims, and this is the last claim, and for the different patient, I do have 2 claims.
[AGENT][NEUTRAL] OK. So, do you have another one for a Chevary or you don't have another one for Chevary?
[CUSTOMER][NEUTRAL] I do have, but it is the same bill amount 396. So I think it's no claim on file. Yeah.
[AGENT][NEUTRAL] OK, so, yeah, that one is not here. Yeah, correct. Mhm.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. So what is the next policy number?
[CUSTOMER][NEUTRAL] So, I need the information for the.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] MM. I'm just opening it.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah, it is 1227.
[CUSTOMER][NEUTRAL] 446
[CUSTOMER][NEUTRAL] M as in Mike, L as [PII].
[AGENT][NEUTRAL] What's the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] It's [PII] and the date of birth is.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] What is the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] [PII] and the bill amount is $2021 even.
[AGENT][NEUTRAL] 200 and how much again?
[CUSTOMER][NEUTRAL] It's 221
[CUSTOMER][NEUTRAL] Dollars even.
[AGENT][NEUTRAL] 221. OK. And that was [PII] for the date of service, correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] There's no claims on file for that date of service.
[CUSTOMER][NEUTRAL] OK on file.
[CUSTOMER][NEUTRAL] OK. So the, the, can I get the effective date of the patient?
[AGENT][NEUTRAL] OK. One moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. Give me just a minute, I found another policy, Miss [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It's still on our claim.
[AGENT][NEUTRAL] OK, let me give you the correct policy number where you need to send the claim to.
[AGENT][NEUTRAL] Let me know when you're ready.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The correct policy number is 02.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] 56
[AGENT][NEUTRAL] 8945.
[CUSTOMER][POSITIVE] Yeah, thank you for the correction.
[AGENT][NEUTRAL] OK, the effective date is [PII].
[AGENT][NEUTRAL] And this one is active at the moment?
[CUSTOMER][NEUTRAL] And may I know the
[CUSTOMER][POSITIVE] OK. Thank you.
[CUSTOMER][NEUTRAL] And the, there is no DSL, right?
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] OK. And the mailing address and the payer ID would be is the same, right?
[AGENT][NEUTRAL] Same.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Thank you for that. Can we go with the last name?
[AGENT][NEUTRAL] What's the date of service?
[CUSTOMER][NEUTRAL] I just have the different patients.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] OK. Um, one moment. You said you only have one more. OK, one moment. Let me just go ahead and finalize this one.
[AGENT][NEUTRAL] OK. Mm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] What is the next policy number?
[CUSTOMER][NEUTRAL] Yeah, it is 01877.
[CUSTOMER][NEUTRAL] 135 M as in Mike L as in Lima, number 8.
[AGENT][NEUTRAL] What's the name and date of birth?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Berm
[CUSTOMER][NEUTRAL] And the date of birth is [PII].
[AGENT][NEUTRAL] What is the date of service?
[CUSTOMER][NEUTRAL] It's [PII] and the bill amount is $394 even.
[AGENT][NEUTRAL] That's [PII].
[CUSTOMER][POSITIVE] That's right.
[AGENT][NEUTRAL] The claim is not on file.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] I know the effective dates of the patient?
[AGENT][NEUTRAL] [PII] and it's still active.
[CUSTOMER][NEUTRAL] That
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome. Is there anything else I may help you?
[CUSTOMER][NEUTRAL] Is there any corrective policy?
[CUSTOMER][NEUTRAL] Is there any correct uh policy ID for the patient or it is the correct policy ID?
[AGENT][POSITIVE] This is the correct policy.
[CUSTOMER][POSITIVE] Oh, thank you.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][POSITIVE] Yeah, I got the information. Thank you for assisting me today. And can I get the call reference number?
[AGENT][NEUTRAL] We don't have reference numbers so you can use my name in today's date.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Yeah, thank you. Have a good day. Bye bye.
[AGENT][POSITIVE] You as well thank you for calling APL. Bye bye.
[CUSTOMER][NEUTRAL] Bye.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Come on. [PII].
[AGENT][NEGATIVE] I hate these computers.
[AGENT][NEUTRAL] Come on.
[AGENT][NEUTRAL] In no sense.
[CUSTOMER][NEGATIVE] You are on hold.