AccountId: 011433970860
ContactId: d112ab3f-67a3-4ac8-b192-8d85da4a6610
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 382480 ms
Total Talk Time (AGENT): 126812 ms
Total Talk Time (CUSTOMER): 149876 ms
Interruptions: 1
Overall Sentiment: AGENT=1.1, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/17/d112ab3f-67a3-4ac8-b192-8d85da4a6610_20250417T15:18_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hello, [PII]. This is [PII] MS [PII], and I have a member with member ID 0236.
[AGENT][NEUTRAL] Can you give me a moment please because I need your call back number. I do apologize. I didn't get any of that I do apologize. I didn't get any of that information that you just provided me with. Uh, first, thanks for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] 3909.
[CUSTOMER][NEUTRAL] 716
[CUSTOMER][NEUTRAL] Uh, actually, uh, I, I want to know the claim status of a member.
[AGENT][POSITIVE] OK, can I get your name and a call back number and I'll be able to assist you.
[CUSTOMER][NEUTRAL] My name is [PII]. Last initial [PII]. And uh the callback number is [PII].
[AGENT][NEUTRAL] And what is the policy number?
[CUSTOMER][NEUTRAL] 02363909
[AGENT][NEUTRAL] And what is this member's name and date of birth that you're calling to check the status of a claim for?
[CUSTOMER][NEUTRAL] Member's name is uh [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And her date of birth?
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] And what is the date of service that you're calling to check the status of a claim for?
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And what is your bill amount?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] $1,293.63.
[AGENT][NEUTRAL] That's the patient's responsibility.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] What is your procedure code?
[CUSTOMER][NEUTRAL] 523 56.
[AGENT][NEUTRAL] Is this for a facility charge or professional charge?
[CUSTOMER][NEUTRAL] Actually, uh, as I can see, your primary insurance already paid the amount of, uh,
[CUSTOMER][NEUTRAL] And uh
[CUSTOMER][NEUTRAL] Uh, as I can see here, uh, $401.45 is patients responsibility.
[CUSTOMER][NEUTRAL] And you are the secondary insurance, so that's why I called you. You received the claim?
[AGENT][NEUTRAL] We have no claim on file with procedure code. Give me that procedure code again.
[CUSTOMER][NEUTRAL] Or
[CUSTOMER][NEUTRAL] 52356 and 4 and 74,420.
[AGENT][NEUTRAL] You said 7
[CUSTOMER][NEUTRAL] 4420. And one more, 52356.
[CUSTOMER][NEUTRAL] We uh we billed on [PII] through paper claim.
[AGENT][NEUTRAL] And what's the bill amount?
[CUSTOMER][NEUTRAL] $1,293.63.
[CUSTOMER][NEUTRAL] For both procedure code.
[AGENT][NEUTRAL] Can you verify where you submitted it to?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And where did you submit the claim to? You said you send it by mail to where?
[CUSTOMER][NEUTRAL] Paper
[AGENT][NEUTRAL] You sent it by mail to what address?
[CUSTOMER][NEUTRAL] Paper claim.
[CUSTOMER][NEUTRAL] I don't have this information.
[AGENT][NEUTRAL] Because I'm not showing the claim on file unfortunately.
[CUSTOMER][NEUTRAL] One moment.
[AGENT][NEUTRAL] And what was your name?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][POSITIVE] Thank you, [PII].
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] OK. Can you provide me the uh uh patient were active on data service?
[AGENT][NEUTRAL] What was the date of service?
[AGENT][NEUTRAL] Yes, the patient was at. What is, what is the date of service, sir, again?
[CUSTOMER][NEUTRAL] Can you uh provide me the,
[CUSTOMER][NEUTRAL] Pa
[CUSTOMER][NEUTRAL] Go ahead.
[AGENT][NEUTRAL] What was the date of service?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And what was your question?
[CUSTOMER][NEUTRAL] Patient was active on this data of service?
[AGENT][POSITIVE] Yes, that is correct. The patient's policy was active.
[CUSTOMER][NEUTRAL] OK. Tell me the uh
[CUSTOMER][NEUTRAL] Effective and termination date.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] This policy has been active since.
[AGENT][NEUTRAL] [PII] and it's currently active, [PII].
[CUSTOMER][NEUTRAL] OK. And uh provide me the payer ID and mailing address, claim mailing address.
[AGENT][NEUTRAL] The payer ID is 60801. It's 60801.
[CUSTOMER][NEUTRAL] Mailing address?
[AGENT][NEUTRAL] The mailing address will be addressed to [PII] department.
[AGENT][NEUTRAL] [PII]. That's [PII]. That's [PII]. Is there anything else that I can assist you with today?
[CUSTOMER][NEUTRAL] OK, tell me your name and uh call reference number.
[AGENT][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] It's [PII], and today's date is a reference because unfortunately we don't provide reference numbers.
[CUSTOMER][NEUTRAL] Your name and today's date, correct?
[AGENT][POSITIVE] Yes, that is correct. Is there anything else that I can assist you with today?
[CUSTOMER][NEUTRAL] No, thank you.
[AGENT][POSITIVE] Thanks for calling APL and have a great day.