AccountId: 011433970860
ContactId: d4e8feb9-b09d-4496-97ed-4a6fa9fa5cf4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 399559 ms
Total Talk Time (AGENT): 147595 ms
Total Talk Time (CUSTOMER): 115839 ms
Interruptions: 1
Overall Sentiment: AGENT=0.8, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/26/d4e8feb9-b09d-4496-97ed-4a6fa9fa5cf4_20250226T19:28_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh yes. Hi, this is [PII] calling from provider's office, uh, to check on a claim.
[AGENT][NEUTRAL] OK, [PII], you have one claim to check status on, is that correct?
[CUSTOMER][NEUTRAL] Uh, yes, I want to check the billing status.
[AGENT][NEUTRAL] You want to check claim status, is that correct?
[CUSTOMER][NEUTRAL] Oh, yes.
[AGENT][NEUTRAL] Yes ma'am, I can help you with that and what is your callback number, [PII]?
[CUSTOMER][NEUTRAL] Uh, yeah, it is [PII] with an extension of [PII].
[AGENT][NEUTRAL] OK, please repeat that. Yes, ma'am. Please repeat your number.
[CUSTOMER][NEUTRAL] Yeah [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And did you say there's an extension, [PII]?
[CUSTOMER][NEUTRAL] Yeah, it is 10498.
[AGENT][NEUTRAL] Thank you. And your patient's policy number, please?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Uh, yes, let me help you with that details. Just give me a second.
[CUSTOMER][NEUTRAL] Sorry. It is 01912978.
[AGENT][POSITIVE] Thank you, one moment.
[AGENT][NEUTRAL] And [PII], any information that I do provide for you today would be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yeah, it is [PII]. Date of birth is [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And the date of service and total bill amount for him please.
[CUSTOMER][NEUTRAL] Yeah. Data service is [PII] with the total charge amount of $511 even 511.
[AGENT][NEUTRAL] And you said date of service is [PII], is that correct?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yeah, [PII].
[AGENT][NEUTRAL] OK, there is no claim on file for this number for this data service.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Yeah, can you please help me with the eligibility for term dates?
[AGENT][NEUTRAL] The effective date is [PII] and it is currently showing.
[AGENT][NEUTRAL] Just one moment.
[AGENT][NEUTRAL] The policy is active. There is no termination date.
[CUSTOMER][NEUTRAL] Just give me a second.
[CUSTOMER][NEUTRAL] Yeah, can you please spell out your name for me?
[AGENT][NEUTRAL] [PII] and when the claim is submitted to APL, you will also need to send us a copy of the primary insurance company's explanation of benefits as well for review. We do have to have that with this type of claim and then once we have processed our claim, we do have a portal that you can check claim status in Cathy by going to secured. [PII].
[CUSTOMER][NEUTRAL] Yeah. Should we move on to the next one? Same patient but different data service?
[AGENT][NEUTRAL] How many
[AGENT][NEUTRAL] Oh, you didn't indicate that you had more than one day of service. How many dates of service do you have for this member?
[CUSTOMER][NEUTRAL] Uh, I do have 3 more data services for this, uh, member.
[AGENT][NEUTRAL] Just one moment.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And the next day of service and total bill amount?
[CUSTOMER][NEUTRAL] It is [PII] with the total charge amount of $105 even $105.
[AGENT][POSITIVE] Thank you one moment.
[AGENT][NEUTRAL] OK, and there is no claim on file for this member for this bill amount for that data service.
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] Yeah, just give me a second.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah. The next data service I have here is
[CUSTOMER][NEUTRAL] It is [PII] with the total charge amount of
[CUSTOMER][NEUTRAL] $145 each.
[AGENT][NEUTRAL] 145. Is that correct?
[CUSTOMER][NEUTRAL] Oh yeah, it is 145.
[AGENT][NEUTRAL] OK, and I do not have a claim on file for this number for this data service for that bill amount.
[CUSTOMER][NEUTRAL] Yup, can you please uh confirm me the mailing address?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Oh, yeah. What is the timely filing limit?
[AGENT][NEUTRAL] There is no timely filing limit and again you will also have to submit along with the claim the primary insurance company's explanation of benefits for each data service.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah. Uh, the next date of service I have here is [PII].
[AGENT][NEUTRAL] Just one moment, [PII].
[AGENT][NEUTRAL] Total bill amount.
[CUSTOMER][POSITIVE] Just give me a second. I'll help you with that.
[CUSTOMER][NEUTRAL] Just for a second.
[CUSTOMER][NEUTRAL] It is $325 even.
[AGENT][NEUTRAL] No claim on file for that bill amount?
[CUSTOMER][NEUTRAL] Just give me a second.
[CUSTOMER][NEUTRAL] Just for a second.
[CUSTOMER][NEUTRAL] What
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] Yeah, thank you so much. Have a nice day.
[AGENT][NEUTRAL] You
[AGENT][NEUTRAL] hello?
[CUSTOMER][NEUTRAL] Oh yes.
[AGENT][NEUTRAL] Is that all I can help you with today, [PII]?
[CUSTOMER][POSITIVE] Yeah. Yeah, yeah. Thank you so much.
[AGENT][POSITIVE] Yes, well, thank you again for you're welcome and thank you for calling APL. I hope you have a nice afternoon.
[CUSTOMER][POSITIVE] Yes, you too bye.
[AGENT][POSITIVE] Thank you. Bye-bye.