AccountId: 011433970860
ContactId: d64bffeb-c8cb-4c5d-b902-8f88aa04364b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 283000 ms
Total Talk Time (AGENT): 111869 ms
Total Talk Time (CUSTOMER): 96322 ms
Interruptions: 0
Overall Sentiment: AGENT=0, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/24/d64bffeb-c8cb-4c5d-b902-8f88aa04364b_20250224T19:36_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] Hey, hi. My name is [PII], and I'm calling from the provider's office to check on a claim status.
[AGENT][NEUTRAL] I'm sorry, what was your name? I didn't understand you.
[CUSTOMER][NEUTRAL] Uh, is, uh, uh, can you hear me right now?
[AGENT][NEUTRAL] Say something else? Yes, I can hear you now. What is your name?
[CUSTOMER][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Uh yes. Uh yes, my name is [PII], which spelled [PII], last initial [PII].
[AGENT][NEUTRAL] OK, [PII], and you're needing claim status, is that correct?
[CUSTOMER][NEUTRAL] Uh, yes, correct. Uh, could you please spell out your first name for me?
[AGENT][NEUTRAL] [PII].
[AGENT][POSITIVE] And [PII], you're welcome. What is a good callback number for you, please?
[CUSTOMER][POSITIVE] Thank you, [PII].
[CUSTOMER][NEUTRAL] Uh, which is [PII]. There is no extension direct line.
[AGENT][NEUTRAL] Thank you. And how many claims [PII], do you have to check status on?
[CUSTOMER][NEUTRAL] Uh, let me check one by one. After giving me, uh, just a second, let me check. Be online.
[CUSTOMER][NEUTRAL] Oh no, actually, I, I only seen one.
[AGENT][NEUTRAL] One, OK. And what is that member's policy number, please?
[CUSTOMER][NEUTRAL] Uh, just a second. Member's policy number is 1528832.
[AGENT][NEUTRAL] 152-883-2, is that correct?
[CUSTOMER][POSITIVE] Uh, correct.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] Any information that I do provide for you today, [PII] will be a verification of benefits and not a guarantee of payment. What is your patient's name, please, and their date of birth?
[CUSTOMER][NEUTRAL] Just a second.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, uh, patient's first name is [PII]. Last name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Thank you and the date of service and total bill amount?
[CUSTOMER][NEUTRAL] Uh, let me check.
[CUSTOMER][NEUTRAL] The date of service is [PII] and total charges are $29,389 even.
[AGENT][NEUTRAL] 29, 839, is that correct?
[CUSTOMER][POSITIVE] Uh yes, correct.
[AGENT][NEUTRAL] And again you said the service date is [PII].
[AGENT][NEUTRAL] To [PII]. Is that correct?
[CUSTOMER][POSITIVE] Correct. Correct.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] OK, so there is no claim on file on this policy for this member, this policy was actually not active for your data service. This policy was active from [PII], and there is no other policy with our company.
[CUSTOMER][NEUTRAL] Oh, but
[CUSTOMER][NEUTRAL] OK. Uh, give me the payer ID.
[AGENT][NEUTRAL] 60801.
[CUSTOMER][NEUTRAL] Uh sorry, uh 60.
[AGENT][NEUTRAL] 801.
[CUSTOMER][NEUTRAL] 801. OK, ma'am.
[CUSTOMER][NEUTRAL] May I know the time the filing limit?
[AGENT][NEGATIVE] There is no timely filing limit again this policy was not active.
[CUSTOMER][NEUTRAL] Yes, I know. Oh yes, I know that.
[AGENT][NEUTRAL] For your date of birth.
[AGENT][NEUTRAL] Uh-huh. OK.
[CUSTOMER][NEUTRAL] I know that this policy is not active, but still I'm asking, may I know the time refunding limit uh for my reference?
[AGENT][NEGATIVE] There is no timely filing limit.
[CUSTOMER][NEUTRAL] OK, no worries. Uh, give me the same mailing address.
[AGENT][NEUTRAL] [PII], and the zip code is [PII].
[CUSTOMER][NEGATIVE] Could you please spell out, uh, could you please spell out that? I'm not getting it.
[AGENT][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And the state is [PII]?
[AGENT][NEUTRAL] And the zip code is [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK. Thank you for giving me this wonderful information. Have a great day. Bye-bye.