AccountId: 011433970860
ContactId: cde6720f-df88-4902-b8bb-8249c544601e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 362779 ms
Total Talk Time (AGENT): 74925 ms
Total Talk Time (CUSTOMER): 184167 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/07/cde6720f-df88-4902-b8bb-8249c544601e_20250107T18:20_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Uh, hi, [PII]. My name is [PII]. Can you hear me?
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] Yes, can you spell that for me?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And do you have a callback number I can get in case we get disconnected?
[CUSTOMER][NEUTRAL] Yeah. [PII].
[AGENT][NEUTRAL] And do you have the
[CUSTOMER][NEUTRAL] And can you please help me with your last name, initial, it's a direct line.
[AGENT][NEUTRAL] My initial is [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And do you have the policy number?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Policy number is 00.
[CUSTOMER][NEUTRAL] 22
[CUSTOMER][NEUTRAL] 97
[CUSTOMER][NEUTRAL] 08
[CUSTOMER][NEUTRAL] 5
[CUSTOMER][NEUTRAL] Then M as in Mary, L as in Lima.
[AGENT][NEUTRAL] And the patient's name?
[CUSTOMER][NEUTRAL] Patient name, it's [PII].
[AGENT][NEUTRAL] And the date of birth?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][POSITIVE] Thank you, [PII].
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] And you were needing claim status or benefits?
[CUSTOMER][NEUTRAL] Claim status.
[AGENT][NEUTRAL] OK, I can look that up for you. What date of service?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, I have two date of service of this member. The first one I have [PII].
[AGENT][NEUTRAL] And what's the charge?
[CUSTOMER][NEUTRAL] Right, I was.
[CUSTOMER][NEUTRAL] Charge amount $50 even $50.
[AGENT][NEUTRAL] Hold on one moment.
[CUSTOMER][NEUTRAL] Yeah, sure.
[CUSTOMER][NEUTRAL] This
[AGENT][NEUTRAL] You said 10, 2, 24?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] No claim on file.
[CUSTOMER][NEUTRAL] No claim on file.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Uh, because the primary, uh, left a co-pay of $27 so that's the reason we forward that claim to the second rate with the same amount.
[AGENT][NEUTRAL] Right, we didn't receive the claim.
[CUSTOMER][NEUTRAL] Didn't receive the claim. OK. Uh, can you please verify all the things, just one moment. What is the payer ID?
[AGENT][NEUTRAL] 60801.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] 60801. OK.
[CUSTOMER][NEUTRAL] And tell me the mailing address once.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK. The state is also uh.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]. Just one moment. And
[CUSTOMER][NEUTRAL] What is the attention?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Thanks.
[CUSTOMER][NEUTRAL] [PII], right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So maybe
[CUSTOMER][NEGATIVE] We have some problem.
[CUSTOMER][NEUTRAL] For the claim submission.
[CUSTOMER][NEUTRAL] Just one moment, let me check. Uh, can you please check the other other one also the claim is on file or not?
[AGENT][NEUTRAL] What is the data service?
[CUSTOMER][NEUTRAL] Uh, October [PII], 2024, 103,030.
[CUSTOMER][NEUTRAL] Charge my own same.
[AGENT][NEUTRAL] No claim, no claim on file.
[CUSTOMER][NEUTRAL] OK I'm on file.
[CUSTOMER][NEUTRAL] Uh, the pay ID just take 60801, right?
[AGENT][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] And it's showing that PO Box 248,950 yeah [PII]. All right, so we will resubmit the claim, OK? Don't worry about that.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Definitely. Can you please provide me the call reference number and also, I need to verify if the member is active on the date of service or not.
[CUSTOMER][NEUTRAL] That means the effective date and the term date.
[AGENT][NEUTRAL] The effective date is [PII].
[AGENT][NEUTRAL] And it turned 11 to 25.
[CUSTOMER][NEUTRAL] 11 on 25. OK.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] That means it's already termed today's date.
[AGENT][NEUTRAL] Yeah, yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And can you please uh verify the timely filing limit?
[AGENT][NEGATIVE] We do not have timely filing.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Please provide me the call reference.
[AGENT][NEUTRAL] We do not have call reference numbers. You can use my name in today's date.
[CUSTOMER][POSITIVE] All right. Thank you so much, [PII], for your help. I've done for this day.
[AGENT][POSITIVE] Thank you, [PII], for calling APL. You have a good day.
[CUSTOMER][NEUTRAL] You too. Bye-bye, bye for now. Bye.