AccountId: 011433970860
ContactId: e7bc390b-703e-4387-ae14-dc671cfe6995
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 385609 ms
Total Talk Time (AGENT): 119235 ms
Total Talk Time (CUSTOMER): 169986 ms
Interruptions: 5
Overall Sentiment: AGENT=0.5, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/12/e7bc390b-703e-4387-ae14-dc671cfe6995_20250312T19:38_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Hey, hi. Uh, my name is [PII]. I'm calling to check on a claim status. Can you help me with that?
[AGENT][NEUTRAL] I'm so sorry, may I have your name again?
[CUSTOMER][NEUTRAL] I'm so sorry. May I have your name again? Yeah, I'm sorry. It's spelled like [PII].
[AGENT][POSITIVE] OK, thank
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Thank you [PII], what is your callback number please?
[CUSTOMER][NEUTRAL] That's [PII]. And that's the direct line.
[AGENT][NEUTRAL] Thank you. What's the policy number?
[CUSTOMER][NEUTRAL] Thank you. What's the policy number? Yeah, it starts with 022926.
[CUSTOMER][NEUTRAL] 66.
[CUSTOMER][NEUTRAL] And the patient name is
[CUSTOMER][NEUTRAL] Give me 1 2nd.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I'm sorry. So the patient's first name is [PII] and the last name is spelled like [PII] And the date of birth is [PII].
[AGENT][NEUTRAL] Thank you, and again you're calling for claim status. I can assist you. What is the date of service and the total charge amount billed?
[CUSTOMER][NEUTRAL] Of the total charge amount billed. Yeah, um.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] With the total bill amount, it's $708 even.
[AGENT][POSITIVE] One moment thank you.
[CUSTOMER][NEUTRAL] And uh I do, sure, check it.
[AGENT][NEUTRAL] I'm sorry, go ahead, please.
[CUSTOMER][NEUTRAL] Sorry, go ahead. Yeah, I do have another uh bill amount with the same date of service for the same patient. So I can just give you that so that you can find the two claims at the same time if it is possible.
[AGENT][NEUTRAL] It is possible. What is that total charge amount?
[CUSTOMER][NEUTRAL] It is that the total amount. Yeah, that is $3,614 even.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, again, that's
[CUSTOMER][NEUTRAL] And that's also going to be the same date of service.
[AGENT][NEUTRAL] Correct, and that was [PII], is that correct?
[CUSTOMER][POSITIVE] That's right.
[AGENT][NEUTRAL] Thank you. One moment. Now also, [PII], you're able to check claim status by visiting our secure portal at [PII]. You'll be able to obtain you'll be from that website as well.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] And public
[AGENT][NEUTRAL] Give me one moment, please.
[CUSTOMER][NEUTRAL] The website as well. Sure. Mhm.
[AGENT][NEUTRAL] OK, I do not show that we have received those claims, no claims, well, both claims are not on file.
[CUSTOMER][POSITIVE] I can make sure that we have those free.
[CUSTOMER][NEUTRAL] OK for that flight.
[CUSTOMER][NEUTRAL] All right. And I do have another bill the amount it's $416. Do you have that claim with you?
[AGENT][NEUTRAL] I'm sorry.
[CUSTOMER][NEUTRAL] For the same data services.
[CUSTOMER][NEUTRAL] I'm sorry.
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Oh, for the same date of services, I do have another batch.
[AGENT][NEUTRAL] I do not have a claim bill for $416 as well.
[CUSTOMER][NEUTRAL] All right. Uh, can you just help me with the patient?
[CUSTOMER][NEUTRAL] Got you. Can you just help me with the patient's plan, effective date and the termination date? Is the member is active for the dose?
[AGENT][NEUTRAL] OK, one moment please, [PII]. Now just to clarify, you're calling to check the claim status of 2 claims or is it 3 claims?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] Great.
[AGENT][NEUTRAL] [PII], are you there?
[AGENT][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Yes, am I audible?
[AGENT][NEUTRAL] You are now. I was asking just to clarify, are you call that's OK. Are you calling to check claim status for 3 separate claims or is it 2 separate claims?
[CUSTOMER][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Uh, I'm
[CUSTOMER][NEUTRAL] Like all the claims you guys like 3 separate claims or are they two separate claims?
[CUSTOMER][NEUTRAL] I just called the 3, for the 3 separate clients for the same patient.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. Now, the effective date for the member shows [PII] and the policy shows active.
[CUSTOMER][NEUTRAL] Got you. And also, can you just provide me the claim's mailing address and the timely filing limit to resubmit the claim?
[AGENT][NEUTRAL] Of course, there is no time filing limit to submit a claim. Our mailing address is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] like
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII], [PII].
[CUSTOMER][NEUTRAL] Mhm. [PII]. Mhm.
[AGENT][NEUTRAL] Payer ID is 60801.
[CUSTOMER][NEUTRAL] Your ID
[CUSTOMER][NEUTRAL] 0801.
[CUSTOMER][NEUTRAL] And there's no time filling much.
[AGENT][NEGATIVE] There is no timely filing limit.
[CUSTOMER][NEUTRAL] Accountly filing limits.
[CUSTOMER][NEUTRAL] All right, so that's all I needed from you today. Uh, can I just get the call reference number? And I'm sorry I missed to get your name.
[AGENT][NEUTRAL] We do not use call reference numbers. My name is [PII]. You can use my name in today's date. My last initial is [PII], and thank you for calling us at APL. You have a good day.
[CUSTOMER][POSITIVE] Thank
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] like
[CUSTOMER][POSITIVE] You, you too, take care. Bye.
[AGENT][POSITIVE] Thank you bye bye.