AccountId: 011433970860
ContactId: d0aa97b1-80c7-4a16-946a-81e332eea121
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 799570 ms
Total Talk Time (AGENT): 122102 ms
Total Talk Time (CUSTOMER): 420734 ms
Interruptions: 14
Overall Sentiment: AGENT=1.8, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/01/d0aa97b1-80c7-4a16-946a-81e332eea121_20250501T20:55_UTC.wav
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[AGENT][POSITIVE] Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yeah, hi, uh, this is [PII] calling from products office to check the claim status. Could you please help me with the claim status?
[AGENT][POSITIVE] Yes, I'll be more than happy to assist you with the claim status, [PII], and how many claims do you have in total today?
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Uh, I have one claim on it.
[AGENT][NEUTRAL] OK, may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]. What was the last four?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you for that. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] 02249239
[AGENT][POSITIVE] Thank you. Hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Yeah, um, last name was [PII]. Uh, first name was uh [PII]. Date of birth was [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. May I have the date of service for the claim and the total bills?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um date of service was um [PII]. Total charge amount was $2,256.
[CUSTOMER][NEUTRAL] I did.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] It.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] And do you mind if I place you on just a brief hold while I locate the claim?
[CUSTOMER][POSITIVE] Yeah, no problem.
[AGENT][POSITIVE] Thank you. Hold on one moment.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] do
[AGENT][NEUTRAL] Hello [PII].
[CUSTOMER][NEUTRAL] Uh yes. No.
[AGENT][POSITIVE] Thank you so much for holding. I apologize for the wait. And what is the name of your the provider's office on the claim?
[CUSTOMER][NEUTRAL] Mm, that was uh Kendall anesthesia Associates.
[CUSTOMER][NEUTRAL] I.
[AGENT][NEUTRAL] And is there any other total bill that that could be on the claim?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] One moment, I'll check. Mm.
[CUSTOMER][NEUTRAL] A total total bill was $2,256 and allowed was uh 1628.
[AGENT][NEUTRAL] OK, so this is the only total bill, then there's no claim on file for your provider for that data service.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh, no claim on file, right? Give me one moment.
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I can.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] 21 to below.
[CUSTOMER][NEUTRAL] Um, uh, uh, hello.
[AGENT][NEUTRAL] Yes, I'm here.
[CUSTOMER][NEUTRAL] Uh, you said no claim, right? Mm, mm. May I know the claim's mailing address and payer ID?
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] Sure, it's [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]. Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Could you spell it for me?
[CUSTOMER][NEUTRAL] I'm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, [PII]
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So, [PII]?
[AGENT][NEUTRAL] The zip code is [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] The pay ID is 60801.
[CUSTOMER][NEUTRAL] OK. Uh, one moment, mm.
[AGENT][NEUTRAL] We have a fax number as well.
[CUSTOMER][NEUTRAL] Uh, what was the TFL?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Uh, timely filing limit.
[AGENT][NEUTRAL] There's no timely filing limit as long as the policy is active on the data service, you can file at any time.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. Uh, can you please verify, is there any reaction, uh, uh.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Uh, there is no timely filing limit, right? Uh, patient is active from, uh, which date? Uh, could you provide me that?
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] Hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So the policy is still active. It was, it's been effective since [PII].
[CUSTOMER][NEUTRAL] It's still active, right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Mhm. OK. Mm.
[CUSTOMER][NEUTRAL] Um, one moment.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] the picture.
[CUSTOMER][NEUTRAL] Uh hello.
[AGENT][NEUTRAL] Yes, I'm here.
[CUSTOMER][NEUTRAL] Yeah, uh, could you please provide me, uh, let me know, um.
[CUSTOMER][NEUTRAL] You will accept electronic claim, right?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] You.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] The claim was submitted through electronic, right?
[AGENT][NEUTRAL] You can submit the claim electronically with the payer ID.
[CUSTOMER][NEUTRAL] We would like to submit time.
[CUSTOMER][NEUTRAL] The pay ID was 60801, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Mhm. Uh, could you please provide me the TFL? You said, uh, no TFL, right, from date of service? No problem patient is still active. Uh, OK. Uh, please cross verify the uh claim mailing address was [PII] City. Zip code was [PII].
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. Uh, just give me one moment. I'll document the notes. Mm.
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I did.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] Um, um, could you spell your name?
[AGENT][NEUTRAL] Yes, my name is [PII] The first initial to my last name is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And call this number?
[AGENT][NEUTRAL] There's no call reference number, but you can use my name in today's date.
[CUSTOMER][NEUTRAL] [PII] and today's date, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] Mm thank you very much, [PII]. Thank you for the information. Um, have a great day. Bye-bye. Stay safe. Take care.
[AGENT][POSITIVE] You're welcome, [PII]. Was there anything else I can assist you with today?
[CUSTOMER][POSITIVE] Um, no, you know, thank you very much. Bye-bye.
[AGENT][POSITIVE] Alright, well thanks for calling APL and I hope you have a good day. Bye-bye.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] uh.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Now what
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] Mm.