AccountId: 011433970860
ContactId: e9b55ea1-5571-4d36-9172-7ac6fa3018ab
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 451220 ms
Total Talk Time (AGENT): 116373 ms
Total Talk Time (CUSTOMER): 156872 ms
Interruptions: 2
Overall Sentiment: AGENT=0.6, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/11/e9b55ea1-5571-4d36-9172-7ac6fa3018ab_20250211T15:50_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII], and I'm calling from the provider's office checking on claims.
[AGENT][NEUTRAL] OK [PII], I can help you with claims. Can I please get your call back number just in case our call is connected?
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] It's uh [PII].
[AGENT][NEUTRAL] Thank you. And then what is the patient's name?
[CUSTOMER][NEUTRAL] OK. Patient is uh [PII].
[AGENT][NEUTRAL] OK, and what is the patient's date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And patients policy number?
[CUSTOMER][NEUTRAL] It's 02274332.
[AGENT][NEUTRAL] OK, let me look that up.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then what is the data service?
[CUSTOMER][NEUTRAL] Um, [PII], with the total charge $225 even.
[AGENT][NEUTRAL] OK, I'm on and what's the name of your facility?
[CUSTOMER][NEUTRAL] It's a metroplex care group.
[CUSTOMER][NEUTRAL] And also, please note, um, this claim was uh
[CUSTOMER][NEUTRAL] Faxed actually, because we tried submitting the claim electronically and got rejected. So we faxed the claim on January.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 150.
[AGENT][NEUTRAL] OK. And do you have the claim number?
[CUSTOMER][NEUTRAL] Oh no, we don't have the claim number.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, alright, I'm gonna put you on a brief hold while I look up the claim for you and I'll be right back.
[CUSTOMER][NEUTRAL] OK, thank you so much. You are on hold.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Hey, can you check to see if your phone's on my Wi Fi?
[AGENT][NEGATIVE] Because the same I've got 2 devices on it, nothing's on it.
[AGENT][NEUTRAL] Hi Ms. [PII], this is [PII] back with you again. So looking on data service of [PII], I'm not finding the claim on file and I don't see where we have received it in January.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Um, give me a moment. Let me confirm the date when the, uh, fax it. Give me a moment.
[AGENT][NEUTRAL] OK. Yes, ma'am. Certainly.
[CUSTOMER][NEUTRAL] Thank you. Uh, yeah, it's uh faxed on [PII] and the fax number, it was [PII].
[AGENT][NEUTRAL] OK. Um, I'm gonna ask for you to refax it. There may have been issues with the fax or it could have been busy and attempted so many times and stopped, but um, go ahead and refax it because I'm not showing that we have received it.
[CUSTOMER][NEUTRAL] Oh,
[CUSTOMER][NEUTRAL] OK, no problem. So I will refax it. So, but I need to use the same fax number or is there any different fax number that can be used at this time?
[AGENT][NEUTRAL] You.
[AGENT][NEUTRAL] I am so sorry Miss [PII] um go ahead and use the same fax number that's the only one that we have.
[CUSTOMER][NEUTRAL] It's OK.
[CUSTOMER][NEUTRAL] OK. So I just want to confirm that it is um
[CUSTOMER][NEUTRAL] 00 my gosh, what it is. Yeah. [PII] and attention to claims. OK. And uh before that, I would also like to know whether this patient was active on the data service. Could you please confirm that for me?
[AGENT][POSITIVE] Yes, that's correct.
[AGENT][POSITIVE] Yes, that's correct.
[AGENT][NEUTRAL] Yes ma'am, give me just a second, I'm putting my note in and I'll go back and look.
[CUSTOMER][NEUTRAL] Yeah, sure, please.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so the policy's effective date is [PII] and the policy is still active.
[CUSTOMER][NEUTRAL] OK, then I will rebuild the relax the claim and also would like to know what is the timely filing limit for submitting claims.
[AGENT][NEUTRAL] We don't have one as long as they're covered on the date of service you can file a claim at any time.
[CUSTOMER][NEUTRAL] Anything
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][POSITIVE] OK. Thank you so much. And also, may I know how you spell your name, please?
[AGENT][NEUTRAL] My name is [PII]
[CUSTOMER][NEUTRAL] [PII] Thank you. I'm sorry, I'm ready for the call reference number.
[AGENT][NEUTRAL] You can use my name and today's date.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] So, once again, thank you very much, sorry, for providing all this valuable information. Anyway, I will refax the uh claim form. Thank you so much. Have a great day. Bye-bye. Take care.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] You you too you have a good one too, Miss [PII]. Thanks for calling APL bye bye.
[CUSTOMER][NEUTRAL] Yeah, but.
[CUSTOMER][NEUTRAL] Yeah