AccountId: 011433970860
ContactId: cb05fde5-5d23-438c-9a68-3724ae425793
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 886659 ms
Total Talk Time (AGENT): 168361 ms
Total Talk Time (CUSTOMER): 285194 ms
Interruptions: 11
Overall Sentiment: AGENT=0.6, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/04/cb05fde5-5d23-438c-9a68-3724ae425793_20250204T17:13_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][POSITIVE] Thank you for calling APR. This is so.
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from provider's office for checking on claim status.
[AGENT][NEUTRAL] OK, um, I can hardly hear you. You're breaking up. Can you repeat?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from provider's office for checking on claim status.
[AGENT][NEUTRAL] OK, I got the claim status, but I cannot hear your name well.
[CUSTOMER][NEUTRAL] OK, I got, but I can hear your name.
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] OK, and may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] The callback number is [PII]. It's a direct line. Could you please spell your name, please?
[AGENT][NEUTRAL] Yes, my name is [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Thank you so much, sir.
[AGENT][NEUTRAL] You're welcome and you're calling from which uh facility or provider?
[CUSTOMER][NEUTRAL] I'm calling from Saint Alphan Regional Medical.
[AGENT][NEGATIVE] I'm sorry, I didn't get that. You're breaking up.
[CUSTOMER][NEUTRAL] I'm
[CUSTOMER][NEUTRAL] I'm calling from Saint Eanres Regional Medical.
[AGENT][NEUTRAL] Let me have the policy number.
[CUSTOMER][NEUTRAL] The member ID is D as in Delta 46802083.
[AGENT][NEUTRAL] And do you see a policy certificate number? It's gonna start with a 0 followed by 7 digits.
[CUSTOMER][NEUTRAL] Do you see your policy certificate number it's gonna.
[CUSTOMER][NEUTRAL] Uh, can I repeat it again?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Do you want me to repeat again the member ID?
[AGENT][NEUTRAL] No, that ID is not ours.
[CUSTOMER][NEUTRAL] No, that's not on.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] It's multiplan only, no?
[AGENT][NEUTRAL] And this is not multi plan. This is APL. Do you have the APL number?
[CUSTOMER][NEGATIVE] This is not working. Do you have the APL number?
[CUSTOMER][NEUTRAL] Now, could you please tell, tell me?
[AGENT][NEUTRAL] Let let me do a name search. Let me have the spelling of the last name.
[CUSTOMER][NEUTRAL] How you doing
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] The last name is [PII] No.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] And what's the spelling of the first name?
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] It's [PII] No.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] I'm still searching, bear with me.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] I'm still searching, bear with me.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] What is his date of birth?
[CUSTOMER][NEUTRAL] What is his date of birth?
[CUSTOMER][NEUTRAL] The date of birth is [PII].
[AGENT][NEUTRAL] Um
[AGENT][NEUTRAL] OK, what is the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] What is your name?
[CUSTOMER][NEUTRAL] The date of service is [PII] and the total bill amount is $342 even.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] No it's [PII].
[CUSTOMER][NEUTRAL] [PII] or [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] You said [PII]?
[CUSTOMER][NEUTRAL] [PII]. Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] You said it's for 342?
[CUSTOMER][NEUTRAL] So it's 322.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, hold one moment.
[AGENT][NEUTRAL] Gonna be a minute. I'm waiting on the EOB to see if this is your claim, OK?
[CUSTOMER][NEUTRAL] I'm waiting on the AB it's.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] And
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, do you know what's the procedure code?
[CUSTOMER][NEUTRAL] Do you know what the procedure code?
[CUSTOMER][NEUTRAL] OK. The CPT code is 4. The first one is 99204.
[CUSTOMER][NEUTRAL] And the second one is 3078504.
[CUSTOMER][NEUTRAL] The next one is 3074 F as in Fox, and last one is 36415.
[CUSTOMER][NEUTRAL] For the 3078 FXM Fox and 307 for FHM Fox, the charge amount is $0.
[AGENT][NEUTRAL] Hm
[AGENT][NEUTRAL] Mm, yeah, it doesn't, it doesn't look like we have received that one. I checked that and I don't see anyone with those codes and that amount for that date of service.
[CUSTOMER][NEUTRAL] The remaining
[CUSTOMER][NEUTRAL] So we have to do that one I check.
[CUSTOMER][NEUTRAL] For that
[CUSTOMER][NEUTRAL] So you are telling that for this state of service.
[CUSTOMER][NEUTRAL] There is no claim on file. Am I right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Just a moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] May I have the policy effective date and term date for this?
[AGENT][NEUTRAL] Mhm. Yes.
[AGENT][NEUTRAL] Policy effective date is [PII] and it is active at the moment. Mhm.
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] 34. Just a moment.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] 7
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] And it is active at the moment.
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] It is still an active, am I right?
[AGENT][NEUTRAL] Mhm, yes, it's still active.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] May I have the time to filing limit for this?
[AGENT][NEUTRAL] We don't have timely funding limits.
[CUSTOMER][NEUTRAL] We don't have
[CUSTOMER][NEGATIVE] There is no timely filing limit to resubmit the claim.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] May I have the claim number, please? Sorry, sorry.
[CUSTOMER][NEUTRAL] May I have the claim mailing address?
[AGENT][NEUTRAL] The address for this one, let me get that for you, OK.
[CUSTOMER][NEUTRAL] I did this one.
[AGENT][NEUTRAL] That is IMA that's [PII].
[CUSTOMER][NEUTRAL] box.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] Egan, Minnesota.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Just
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] May I have your pay ID please?
[AGENT][NEUTRAL] Sure, the payer ID is 64556.
[CUSTOMER][NEUTRAL] And the pay ID is 455.
[CUSTOMER][NEUTRAL] It's 64556. Am I right?
[AGENT][POSITIVE] Mhm. Correct.
[CUSTOMER][NEUTRAL] May I have the tax ID?
[AGENT][NEUTRAL] The one I'm sorry?
[CUSTOMER][NEUTRAL] I just need the tax ID for this.
[AGENT][NEUTRAL] You said the fax or the tax?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Tax, tax ID. T as in Tango.
[AGENT][NEUTRAL] What tax ID do you need?
[CUSTOMER][NEUTRAL] That's why I
[CUSTOMER][NEUTRAL] I just need for this claim tax ID.
[AGENT][NEUTRAL] But I don't have a claim to give you a tax ID.
[CUSTOMER][NEUTRAL] But I don't have
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So the payment ID is 64556. Am I right?
[AGENT][NEUTRAL] 645-56, correct.
[CUSTOMER][NEUTRAL] Pa.
[CUSTOMER][NEUTRAL] Could you please tell me that, uh,
[CUSTOMER][NEUTRAL] Uh, till how many days are left to to resubmit the claim?
[AGENT][NEGATIVE] There's no timely filing limit.
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] You can submit this claim through electronically or a paper.
[AGENT][NEUTRAL] You can send it by mail or electronic.
[CUSTOMER][NEGATIVE] I don't wanna
[CUSTOMER][NEUTRAL] Uh, could you please provide me the fax number as well?
[AGENT][NEUTRAL] We don't, there's not a fax number to IMA.
[CUSTOMER][NEUTRAL] what
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Could you please provide me the call reference number, please?
[AGENT][NEUTRAL] We don't have a reference numbers you can use my name in today's name.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] Thank you so much for for assisting me.
[AGENT][POSITIVE] You're welcome. Is there anything else I can help you with today?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] No, thank you so much for.
[CUSTOMER][NEUTRAL] Right
[AGENT][POSITIVE] OK. You're welcome and thank you for calling APL. Have a good day.
[CUSTOMER][POSITIVE] You too. Have a good day
[CUSTOMER][POSITIVE] Thank you bye bye.
[AGENT][POSITIVE] You're welcome, bye bye.