AccountId: 011433970860
ContactId: eaadc4bd-4c31-4aa2-987b-2054f0e449f8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 275420 ms
Total Talk Time (AGENT): 147173 ms
Total Talk Time (CUSTOMER): 63079 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/13/eaadc4bd-4c31-4aa2-987b-2054f0e449f8_20250213T13:15_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yeah, hi, good morning. This is [PII] from provider's office. I'm trying to verify claim status.
[CUSTOMER][NEUTRAL] the
[AGENT][NEUTRAL] OK, did you say that your name is [PII]?
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] OK, [PII], and you're needing claim status. Is that also correct?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Yes, I can help you with that. And [PII], what is a good callback number for you please?
[CUSTOMER][NEUTRAL] [PII]. It's my direct line.
[AGENT][NEUTRAL] Thank you and [PII], how many claims do you have to check status on?
[CUSTOMER][NEUTRAL] Uh, just one claim.
[AGENT][NEUTRAL] OK. And what is that member's policy number?
[CUSTOMER][NEUTRAL] Let me verify that. It's uh 1491885.
[AGENT][POSITIVE] OK, thank you one moment please.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, and [PII], any information that I do provide for you today will be a verification of benefits and not a guarantee of payments.
[AGENT][NEUTRAL] What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII] Has. Date of birth is [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And what is your date of service and total bill amount?
[CUSTOMER][NEUTRAL] Um, [PII] was totally billed for $110 even.
[AGENT][NEUTRAL] Did you say [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, so the claim num the policy number rather [PII] that you gave me is an old policy number?
[AGENT][NEUTRAL] The correct policy number that you should have for this number is 025457440.
[AGENT][NEUTRAL] With an effective date of [PII] and it is currently active no term date, give me just one moment. OK, so we do not have a claim on file for him for that data service.
[AGENT][NEUTRAL] Now this is the supplemental policy, [PII], to his primary insurance. So when you do submit the claim to APL for review, we must also receive a copy of the primary insurance company's explanation of benefits as well.
[CUSTOMER][NEUTRAL] Perfect. So may I know the mailing address to submit the claim?
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] And the zip code is [PII].
[AGENT][NEUTRAL] And also [PII], once we have processed our claim, we have a portal that you should be able to check claim status and also have access to the explanation of benefits for APL by going to [PII].
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Got it. And uh is there any fax number to submit the claim?
[AGENT][NEUTRAL] [PII] attention claims.
[CUSTOMER][NEUTRAL] And uh may I have the electronic pay ID please?
[AGENT][NEUTRAL] 60801.
[CUSTOMER][NEUTRAL] Got it. And is there any timely limit to submit the claim?
[AGENT][NEGATIVE] There is not. No.
[CUSTOMER][POSITIVE] Yeah, perfect. And thanks, [PII], that's it for today. May I have the reference number, please?
[AGENT][NEUTRAL] OK. Yes, you would use my name along with today's date.
[AGENT][POSITIVE] So that is all, [PII], that I can help you with. Thank you again for calling APO and I hope you have a great day.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] You too. Bye.
[AGENT][NEUTRAL] Bye bye.