AccountId: 011433970860
ContactId: d4abc3a8-4504-4787-af9d-c6193aad6174
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 473000 ms
Total Talk Time (AGENT): 96983 ms
Total Talk Time (CUSTOMER): 193017 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/17/d4abc3a8-4504-4787-af9d-c6193aad6174_20250317T21:22_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey, hi, this is [PII] calling from [PII]'s office to check on the claim status.
[AGENT][POSITIVE] All right, [PII], I'm happy to check on a claim for you today. May I have the patient's policy number?
[CUSTOMER][NEUTRAL] Yes. It is 60801.
[AGENT][NEUTRAL] And that's actually our payer ID. Do you have their name or social?
[CUSTOMER][NEUTRAL] Oh, sorry, give me a moment. I'll just look on it, OK?
[CUSTOMER][NEUTRAL] Yes, I do have the social of the number.
[CUSTOMER][NEUTRAL] And it is
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Alright, thank you. Give me just one moment, let me try and search by this.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] May I have the patient's first and last name, please?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] And the patient's last name is [PII].
[CUSTOMER][NEUTRAL] And the first name is [PII]
[AGENT][NEUTRAL] May I have the date of birth?
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][POSITIVE] Thank you. Data service?
[CUSTOMER][NEUTRAL] D of service was [PII].
[AGENT][NEUTRAL] In the charged amount.
[CUSTOMER][NEUTRAL] $13,193.25.
[AGENT][NEUTRAL] Do you have an amount after the primary?
[CUSTOMER][NEUTRAL] Uh, yes. We have the primary process EOB with us.
[CUSTOMER][NEUTRAL] So, yes.
[CUSTOMER][NEUTRAL] Uh, you need the primary be to process this claim.
[AGENT][NEUTRAL] I'm wondering what the bill amount is after the primary paid.
[CUSTOMER][NEUTRAL] Oh sorry. It was 22 $2,236 even.
[AGENT][POSITIVE] Alright thank you one moment.
[AGENT][NEUTRAL] OK, I'm not sharing a claim on file for that billed amount.
[CUSTOMER][NEUTRAL] OK, give me a moment.
[CUSTOMER][NEUTRAL] We bill via mailing address. I'll just confirm with the mailing address. If it is wrong, just let me know, OK? The mailing address will bill to [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]. Is this the correct mailing address too?
[AGENT][POSITIVE] That is correct, yes.
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] OK. Do you have any payer ID?
[AGENT][NEUTRAL] The payer ID is 60801.
[CUSTOMER][NEUTRAL] OK. What is the effective and the term of the member?
[AGENT][NEUTRAL] Uh, effective date is [PII]. Patient is still active, no term date.
[CUSTOMER][NEUTRAL] No, um, OK. May I know uh the payer name exactly?
[AGENT][NEUTRAL] Uh, American Public Life.
[CUSTOMER][NEUTRAL] OK. And payer phone number is [PII]. Is this the correct number we dialed to?
[AGENT][POSITIVE] Mhm. That is correct, yup.
[CUSTOMER][NEUTRAL] Uh, give me a moment.
[CUSTOMER][NEUTRAL] And group name?
[AGENT][NEUTRAL] Group name is K.
[AGENT][NEUTRAL] And see.
[AGENT][NEUTRAL] Lake City.
[CUSTOMER][NEUTRAL] OK and see Lake City.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Give me a moment.
[CUSTOMER][NEUTRAL] OK. What is the group number?
[AGENT][NEUTRAL] 26,100.
[CUSTOMER][NEUTRAL] OK. And uh the member name which I have given is the policyholder or he's a subscriber?
[AGENT][NEUTRAL] Uh, both. He is the holder and the subscriber, an individual policy.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] OK. So, may I know what is the timely filing to resubmit this claim?
[AGENT][NEGATIVE] No timely filing.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, my, uh, give me a moment. I'll just, uh, have a look on it. I have taken all the information that I need to take. Give me a second.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] take that.
[CUSTOMER][NEUTRAL] Go
[CUSTOMER][NEUTRAL] OK. Uh, what is your plan type?
[AGENT][NEUTRAL] We're the secondary insurance, so this is a meddling plan.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Uh, sorry?
[AGENT][NEUTRAL] Medin plan.
[CUSTOMER][NEUTRAL] Madeline plan, OK.
[CUSTOMER][NEUTRAL] Give me a moment and I'll just have a look again.
[CUSTOMER][NEUTRAL] And now we can go to the payer ID, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] OK, uh, thank you so much for this information, and may I get the call reference number and another with this call?
[AGENT][NEUTRAL] Call reference is my name with my last initials and today's date. My name again is [PII], that's [PII] My last initial is [PII].
[CUSTOMER][POSITIVE] Thank you so much for this information. Have a great day ahead.
[AGENT][NEUTRAL] You too bye bye.
[CUSTOMER][NEUTRAL] Yeah.