AccountId: 011433970860
ContactId: d59ab4fc-3a35-4c9d-b86b-43aa449a8bca
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 504220 ms
Total Talk Time (AGENT): 157732 ms
Total Talk Time (CUSTOMER): 346717 ms
Interruptions: 11
Overall Sentiment: AGENT=1.1, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/28/d59ab4fc-3a35-4c9d-b86b-43aa449a8bca_20250328T18:27_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yes. Hi. My name is [PII]. I'm calling from provider office to check on claim status. Could you please help me out?
[AGENT][POSITIVE] It would be my pleasure to assist you with claim status, [PII]. What is the callback number?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] And the callback number will be [PII] and the extension is [PII].
[AGENT][NEUTRAL] [PII]. Thank you, [PII] and the policy number for the patient?
[CUSTOMER][NEUTRAL] It's uh 785-511.
[AGENT][NEUTRAL] And [PII], what is the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yes. Uh, the patient's name is [PII], and the date of birth will be [PII].
[AGENT][NEUTRAL] All right, thank you. And [PII], do you have the claim number or date of service?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] Uh, the date of service will be [PII].
[AGENT][NEUTRAL] And what is the billed amount, please?
[CUSTOMER][NEUTRAL] Yes. Uh, the bill amount is $487.18.
[CUSTOMER][NEUTRAL] You resubmit it.
[AGENT][NEUTRAL] Do you happen to have a CPT code available for that claim?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, uh, the CPT is D as in Delta 9220 A as in Alpha.
[AGENT][NEUTRAL] That's the procedure code?
[CUSTOMER][NEUTRAL] Yes, uh yes.
[CUSTOMER][NEUTRAL] you go.
[AGENT][NEUTRAL] I am checking the claims for data service 31124 for my Marker and I do not have.
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] Are you.
[AGENT][NEUTRAL] A claim on file for that date of service for that billed amount of 48718.
[CUSTOMER][NEUTRAL] The uh sorry.
[CUSTOMER][NEUTRAL] Uh, sorry, the CPT is 00920.
[AGENT][NEUTRAL] Yeah, I don't have that claim on file.
[CUSTOMER][NEUTRAL] OK. Um,
[CUSTOMER][NEUTRAL] OK. Uh, could you please provide me the mailing address so I can, uh, resubmit the claim.
[AGENT][NEUTRAL] Yes, you can mail that claim to [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Sorry? Could you
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] Uh, [PII]
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It's, yeah, it's [PII]
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] And that is for [PII], the state.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And the zip code is [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And you can also fax the claim directly to our claims department with the primary EOB.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK. Uh, you need, you need, uh, primary will be along with the claim, right?
[AGENT][NEUTRAL] Yes, ma'am. We're secondary to the policyholders' major medical.
[CUSTOMER][NEUTRAL] OK. May I know the timely filing limit?
[AGENT][NEGATIVE] There's no timely filing.
[CUSTOMER][NEUTRAL] In the
[CUSTOMER][NEUTRAL] And could you please spell out your name for my documentation?
[AGENT][NEUTRAL] My name is [PII]
[CUSTOMER][NEUTRAL] I.
[AGENT][NEUTRAL] First initial and my last name is [PII].
[CUSTOMER][NEUTRAL] A
[CUSTOMER][NEUTRAL] [PII], right?
[AGENT][POSITIVE] That's right.
[CUSTOMER][NEUTRAL] Any issue. And the last name, sorry for asking again. OK. And I have a one, I mean two more claims with the same uh same number with different date of service. Could you please help me out?
[AGENT][NEUTRAL] No problem. The last initial is [PII].
[AGENT][NEUTRAL] Certainly I can help you with that. What's the next date of service?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes. Uh, just a minute.
[CUSTOMER][NEUTRAL] The date of service will be [PII] and the bill amount is $355 even.
[AGENT][NEUTRAL] No claim on file for that data service.
[CUSTOMER][NEUTRAL] OK. Uh, this is also the same, the [PII]. And uh [PII] City and uh [PII].
[CUSTOMER][NEUTRAL] And there is no TSL, right?
[AGENT][POSITIVE] That is correct.
[AGENT][POSITIVE] That's right.
[CUSTOMER][NEUTRAL] OK. And
[CUSTOMER][NEUTRAL] The next date of service will be.
[CUSTOMER][NEUTRAL] Uh, just a minute. Uh, the next date of service will be [PII] and the bill amount is $975.82.
[CUSTOMER][NEUTRAL] OK. Oh, fine. And shall we move to the next number?
[AGENT][NEUTRAL] And no claim on file for that data service either.
[AGENT][NEUTRAL] For that amount.
[AGENT][NEUTRAL] One moment, let me notate this if you don't mind.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] I.
[AGENT][POSITIVE] All right, [PII], I'm ready for the next policy number.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes. Uh, the next member ID will be 004004909.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And that patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yes. Uh, the patient's name is [PII]. um, the spell out is [PII]. And the last initial of the first name is [PII], and the patient.
[AGENT][NEUTRAL] And let me, let me, I'm sorry, I didn't mean to interrupt you, [PII]. Did you say the policy number is 00400490?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] 94909.
[AGENT][NEUTRAL] 499
[CUSTOMER][NEUTRAL] 4909.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] OK. Repeat the whole number if you don't mind because I'm not able to pull that up.
[CUSTOMER][NEUTRAL] Uh yes. Yes, yes. Uh, it's 004004909.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So that is not an APL policy number.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh, as I checking in our system, uh, this is the one.
[CUSTOMER][NEUTRAL] OK. I'll red again. OK. Uh, could you please provide me the call reference number?
[AGENT][NEUTRAL] The call reference number is my name and today's date, and I spell my name [PII].
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK. Thank you for providing all this information. Have a nice day. Bye-bye.
[AGENT][POSITIVE] My pleasure to assist you and thank you for calling APL Gracie. Is there anything else I can help you with today?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK. Thank you.
[AGENT][POSITIVE] Thank you for calling