AccountId: 011433970860
ContactId: d5974da4-b03f-41f2-a46b-9b5529fb8d5a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 253039 ms
Total Talk Time (AGENT): 100319 ms
Total Talk Time (CUSTOMER): 126113 ms
Interruptions: 2
Overall Sentiment: AGENT=0.3, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/18/d5974da4-b03f-41f2-a46b-9b5529fb8d5a_20250218T19:20_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm calling from provider's office. I'm here to know the status of the claim.
[AGENT][NEUTRAL] Sure, I can check on a claim for you. I'm sorry, what did you say your name was?
[CUSTOMER][NEUTRAL] My name is [PII]. I'll spell it out for you. It's [PII] [PII]. And also, could you please spell it out for me?
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Sure, it's [PII].
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] May you said your last name, please?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] Of course. And then can I get a good call back number from you just in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. Do you have the policy number?
[CUSTOMER][NEGATIVE] No thanks.
[AGENT][NEUTRAL] You don't have the policy number?
[CUSTOMER][NEUTRAL] Yes, I have.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, just give me a moment.
[CUSTOMER][NEUTRAL] The policy number is 023-07621.
[AGENT][NEUTRAL] OK, thank you and what was the name and date of birth for the insured?
[CUSTOMER][NEUTRAL] Yes, the member name is [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you for verifying that and what was the date of service for this claim?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] The date of service is [PII].
[CUSTOMER][NEUTRAL] And the bill amount is $3,938.75.
[AGENT][NEUTRAL] OK, that was [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, thank you. One moment please.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] But
[AGENT][NEUTRAL] OK, so I'm not showing that we've received any claims for that date of service.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So could you please provide me your claim mailing address?
[AGENT][NEUTRAL] Yes, and I've also got a fax number and a payer ID if you'd like, uh, so that mailing address is [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And that is in [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Zip code is [PII].
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] You.
[CUSTOMER][NEUTRAL] OK, and what's the fax number where we can submit the claim?
[AGENT][NEUTRAL] Of course the fax number is [PII].
[CUSTOMER][NEUTRAL] So
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] [PII]. And what's your payer ID?
[AGENT][NEUTRAL] 60801
[CUSTOMER][NEUTRAL] We need to provide that.
[CUSTOMER][NEUTRAL] Could you please repeat again?
[AGENT][NEUTRAL] 60801.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK. What's the patient effective and term date, please?
[AGENT][NEUTRAL] Yes, the effective date was [PII].
[CUSTOMER][NEUTRAL] I.
[AGENT][NEUTRAL] And the termination date was [PII].
[CUSTOMER][NEUTRAL] OK, and what's the timely filing to submit the claim?
[AGENT][NEGATIVE] There is no timely filing limit.
[CUSTOMER][NEUTRAL] OK, as you said, there is no claim on file, and as I'm checking here, previously claims submitted maintained but not received yet. So what can I do? I'll resubmit this claim via fax.
[AGENT][NEUTRAL] You can, yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK. Thank you so much. Thank you for the details. What's the reference number for our call, please?
[AGENT][NEUTRAL] Of course.
[AGENT][NEUTRAL] It would just be my first name, last initial, and today's date, um, and then was there anything else I could help you with?
[CUSTOMER][POSITIVE] No, thank you so much. Thank you for this information. You have a wonderful day.
[AGENT][POSITIVE] Of course, yeah, thanks for calling APL you too bye bye.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Bye for now.