AccountId: 011433970860
ContactId: d9c2c0a2-f591-4af7-bdfa-6ad56ee75b86
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 484369 ms
Total Talk Time (AGENT): 114365 ms
Total Talk Time (CUSTOMER): 96995 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=-0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/11/d9c2c0a2-f591-4af7-bdfa-6ad56ee75b86_20250311T18:49_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII] calling from the Action Medical Center to check on the payment status for a patient.
[AGENT][POSITIVE] OK, well, I'll be more than happy to help you with the claim status and [PII], may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure. It's [PII].
[AGENT][NEUTRAL] Thank you for that. And may I have a um the member's policy number, sorry.
[CUSTOMER][NEUTRAL] Sure. The member's policy number is 785116.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Sure. Patient's name is [PII] and the date of birth of the patient is [PII].
[AGENT][NEUTRAL] Thank you for that. And all the information provided is a verification of benefits, not a guarantee of payment. And may I have the date of service and the total bill for the claim?
[CUSTOMER][NEUTRAL] Sure. The date of service is [PII] for the total bill amount of
[CUSTOMER][NEUTRAL] $20,521.66.
[AGENT][NEUTRAL] $20,521.60.
[CUSTOMER][NEUTRAL] 66 cents. 2 6s.
[AGENT][NEUTRAL] All right, hold on one moment.
[AGENT][NEUTRAL] And do you mind if I place you on just a brief hold, [PII]?
[CUSTOMER][POSITIVE] Yeah, sure, take your time.
[AGENT][NEUTRAL] Alright, hold on one moment. Thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Oh, OK, wait, so the policy.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Hello, [PII].
[CUSTOMER][NEUTRAL] Yes, I'm here.
[AGENT][NEUTRAL] Thank you so much for holding. I apologize for that wait. So we received quite a few claims for [PII], but none of the claims that we received have the total bills that you provided. Um, is there any other amounts that could be?
[CUSTOMER][NEUTRAL] Uh, well, the claim has already been processed by the primary insurance and left a balance amount of $5,598.53. Maybe, could you please check into that?
[AGENT][NEUTRAL] So of the claims that we've received for that date of service, I went through each claim and looked at all the total bills. None of them total $20,521.66. Um, none of them are over.
[CUSTOMER][NEUTRAL] OK, OK.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] I can understand that. No worries. Uh OK. So just in case if you're able to send or resubmit this claim, may I ask what is the timely filing limit to send a secondary?
[AGENT][NEUTRAL] Sure, there's no timely filing as long as the policy is active on the data service, you can file at any time. Excuse me, sorry.
[CUSTOMER][POSITIVE] Perfect. No worries. Thank you very much for that. Give me one quick moment. Sir, could you please check whether the patient is eligible for the data service?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, so this data service was
[AGENT][NEUTRAL] [PII]. So yes, the um this policy was active from [PII], so it was active on the data service.
[CUSTOMER][POSITIVE] Perfect. Thank you very much for confirming that. Just give me one quick minute to talk about that.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] No [PII].
[CUSTOMER][NEUTRAL] 3554. Can I have the call reference number for this call, please?
[AGENT][NEUTRAL] Sure, um, so there's no call reference number. You can use my name in today's date. The first initials of my last name is [PII].
[AGENT][NEUTRAL] And just for the call again, all the information provided was a verification of benefits, not a guarantee of payment. [PII], was there anything else I could assist you with today?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][POSITIVE] No, that is all. Thank you very much for asking. Have a wonderful day ahead and take care.
[AGENT][POSITIVE] You also, and thanks for calling APL. Bye-bye.
[CUSTOMER][POSITIVE] It was a pleasure.
[CUSTOMER][NEUTRAL] Bye bye.