AccountId: 011433970860
ContactId: e63f8362-e63c-421a-a62e-1e985bfe1fdb
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 362769 ms
Total Talk Time (AGENT): 141445 ms
Total Talk Time (CUSTOMER): 101569 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/28/e63f8362-e63c-421a-a62e-1e985bfe1fdb_20250428T18:59_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] Hi, [PII]. My name is [PII]. I'm calling from the facility. I'm just checking for a time, sir, claim status.
[AGENT][NEUTRAL] OK, [PII], you have one claim to check status on, is that correct?
[CUSTOMER][POSITIVE] Yeah, that's correct.
[AGENT][POSITIVE] Yes, I can help you with that, [PII]. And what is your callback number, please?
[CUSTOMER][NEUTRAL] Sure, the callback number is [PII].
[CUSTOMER][NEUTRAL] [PII]. It's direct line. Oh sorry, I just use the wrong one. The callback number is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]. Is that correct?
[CUSTOMER][POSITIVE] Yeah, that's right.
[AGENT][NEUTRAL] OK, thank you. And [PII], what is the patient's policy number?
[CUSTOMER][NEUTRAL] Sure. The policy number is going to be 022.
[CUSTOMER][NEUTRAL] 846
[CUSTOMER][NEUTRAL] 24 M as in Mike L as in Lima. 7.
[AGENT][NEUTRAL] OK, thank you, one moment here while I get the member's information pulled up please.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And any information that I do provide for you today here it will be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth?
[CUSTOMER][NEUTRAL] Sure. Um, the member's name is [PII], and the date of birth, [PII].
[AGENT][NEUTRAL] OK, so that date of birth does not match that name.
[CUSTOMER][NEUTRAL] Oh sorry. The member's name is, it's uh it's [PII], and [PII].
[AGENT][NEUTRAL] OK, so who is the patient?
[CUSTOMER][NEUTRAL] Yeah, the patient's name is [PII].
[AGENT][NEUTRAL] With the [PII], date of birth?
[CUSTOMER][POSITIVE] That's correct. Yeah.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And what is the date of service and total bill amount for her place, [PII]?
[CUSTOMER][NEUTRAL] Sure. Um, the date of service of the claim is on [PII], yeah, that's the single date of service. [PII].
[AGENT][NEUTRAL] Uh-huh, and the build the mouth.
[CUSTOMER][NEUTRAL] $11,982.10.
[AGENT][NEUTRAL] OK. 11982.10. Is that correct?
[CUSTOMER][POSITIVE] Yeah, that's right.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, so [PII], I did not have a claim on file for her for this data of service and that bill amount.
[CUSTOMER][NEUTRAL] OK. May I get the policy effective date and the term date, please?
[AGENT][NEUTRAL] Yes, one moment.
[AGENT][NEUTRAL] So the policy is active with an effective date of [PII].
[AGENT][NEUTRAL] And this is a supplemental policy [PII] to her primary insurance. So when you all send the claim to APL you will also need to include a copy of the primary insurance company's explanation of benefits as well.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then once we have processed the claim here at APL we do have a portal that you can also uh check claim status in and the website for our portal Harry is secured.
[CUSTOMER][NEUTRAL] Then
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] Am [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK. Then may I get the client's mailing address, please?
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] That's [PII].
[AGENT][NEUTRAL] The zip code is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, then may I get the pay ID please?
[AGENT][NEUTRAL] 60801.
[CUSTOMER][POSITIVE] I get the family friendly.
[AGENT][NEUTRAL] No timely filing limits?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEGATIVE] There is no timely filing limit.
[CUSTOMER][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] OK then um let me just check that one moment.
[AGENT][NEUTRAL] I'm sorry, what did you say, [PII]?
[CUSTOMER][NEUTRAL] Then may I get the order?
[CUSTOMER][NEUTRAL] Yeah, I think I just get all the information about the claim. Then may I get the call reference?
[AGENT][NEUTRAL] Uh, yes, you would use my name that I gave you along with today's date.
[AGENT][POSITIVE] And is there anything else I could help you with? Absolutely, you're welcome.
[CUSTOMER][POSITIVE] Yeah, thank you, [PII]. Thank you for assisting.
[CUSTOMER][NEUTRAL] I think I can get
[CUSTOMER][POSITIVE] Thank you for assisting for this time and thank you. Have a great day.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Well, I hope you have a great day too, and thank you again for calling APL.
[CUSTOMER][NEUTRAL] Bye-bye.
[AGENT][NEUTRAL] Mm, bye-bye.