AccountId: 011433970860
ContactId: eb75adcd-6be6-49f3-8891-3143c3473d9a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 401140 ms
Total Talk Time (AGENT): 150805 ms
Total Talk Time (CUSTOMER): 148261 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/05/eb75adcd-6be6-49f3-8891-3143c3473d9a_20250305T17:59_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII] and my last name is [PII]
[AGENT][NEUTRAL] I'm so sorry. I can't I can't hardly hear you.
[CUSTOMER][NEUTRAL] Please tell me your last name you should.
[CUSTOMER][NEUTRAL] So hi, [PII]. My name is [PII] and my last name is [PII] Could you please tell me your last name [PII]?
[AGENT][NEUTRAL] S
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] So, [PII].
[AGENT][NEUTRAL] And how can I help you today, [PII]?
[CUSTOMER][NEUTRAL] Yes, I.
[CUSTOMER][NEUTRAL] So I'm checking on a cream.
[AGENT][NEUTRAL] OK, [PII], you have one claim that you're needing status on, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Yes, I can help you with that. And what is your callback number, please?
[CUSTOMER][NEUTRAL] [PII] and direct line.
[AGENT][NEUTRAL] I'm sorry. Say the number again, please?
[CUSTOMER][NEUTRAL] [PII]. And it's a direct line.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] Thank you. And what is the member's policy number, [PII]?
[CUSTOMER][NEUTRAL] A as in Alpha, 1,043,330,200.
[AGENT][NEUTRAL] OK, now, [PII], thank you, but that is not a policy number for our company. What company are you trying to reach?
[CUSTOMER][NEUTRAL] Uh, let me double check. Wait.
[CUSTOMER][NEGATIVE] Oh sorry, that's my mistake.
[AGENT][NEUTRAL] That's OK.
[CUSTOMER][NEUTRAL] So the policy, so the policy number is 02494804ML8.
[AGENT][NEUTRAL] Thank you one moment while I get all of the members' information pulled up.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] And any information that that I do provide for you would be a verification of benefits and not a guarantee of payment. What is your patient's name please and their date of birth?
[CUSTOMER][NEUTRAL] [PII] and date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you. One moment.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] But.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And what is the date of service and total bill amount for her, please?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] It's [PII] and bill amount is $1,403.84.
[AGENT][NEUTRAL] OK. Thank you. One moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] like
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And what is the name of the provider?
[AGENT][NEUTRAL] The group?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the group name?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so the group name is.
[CUSTOMER][NEUTRAL] Infectious disease physicians.
[AGENT][NEUTRAL] OK, so I do not have a claim on file for her for this state of service and that total bill amount.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] Now, if you will be filing.
[CUSTOMER][NEUTRAL] So for this.
[CUSTOMER][NEUTRAL] So have you found the patient?
[AGENT][NEUTRAL] Yes, sir, and there is no claim on file for this state of service and this total bill amount that you provided for me.
[CUSTOMER][NEUTRAL] Yeah that one.
[AGENT][NEUTRAL] So when you
[CUSTOMER][NEUTRAL] Yes, so could you please tell me the ID?
[AGENT][NEUTRAL] 60801.
[CUSTOMER][NEUTRAL] you
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] And when you do file the claim Max with APL, we will also have to have a copy of the primary insurance company's explanation of benefits as well.
[CUSTOMER][NEUTRAL] Like.
[CUSTOMER][NEUTRAL] OK. And what is your timely filing limit?
[AGENT][NEGATIVE] There is no timely filing limit?
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] And which documents will be needed.
[AGENT][NEUTRAL] We will need the claim form and the primary insurance company's explanation and benefits.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Claim form and you be of primary insurance.
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] And then once the claim has been filed and processed with APL Max, we also have a portal that you will be able to check our claim status in by going to [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So do you, could you send the mailing address?
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] And the zip code is [PII].
[CUSTOMER][NEUTRAL] Could you please repeat the zip code?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] M
[CUSTOMER][NEUTRAL] OK. So, you just tell me the call reference number.
[AGENT][NEUTRAL] My name and today's date.
[CUSTOMER][NEUTRAL] Oh, that's [PII] and today's date.
[AGENT][POSITIVE] That is correct, yes, sir.
[AGENT][NEUTRAL] And is there anything else, [PII], that I can help you with?
[CUSTOMER][POSITIVE] So thank you, [PII].
[CUSTOMER][POSITIVE] OK, [PII], thank you for all the information you have provided me. Hope you have a wonderful day.
[AGENT][NEUTRAL] Oh.
[AGENT][POSITIVE] Oh, you're very welcome. It was my pleasure and thank you for calling APL. I hope you have a very nice uh afternoon yourself.
[CUSTOMER][NEUTRAL] Yes, bye for now.
[AGENT][POSITIVE] Uh-huh, thank you. Bye-bye.
[CUSTOMER][NEUTRAL] Bye-bye.