AccountId: 011433970860
ContactId: eddadf40-be42-4146-aedf-9ca2385fd35b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 414100 ms
Total Talk Time (AGENT): 150612 ms
Total Talk Time (CUSTOMER): 106404 ms
Interruptions: 1
Overall Sentiment: AGENT=1.3, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/27/eddadf40-be42-4146-aedf-9ca2385fd35b_20250527T19:57_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, this is [PII] and my Shell is [PII] calling from provider's office to check on a claim status. If you don't mind, could you please spell your name for me?
[AGENT][NEUTRAL] [PII], what is your callback number?
[CUSTOMER][NEUTRAL] Essential, please, and my callback number is [PII].
[AGENT][NEUTRAL] Thank you. And you said that you have one claim that you need to check status on. Is that correct, [PII]?
[CUSTOMER][NEUTRAL] I have 2 plans to check.
[AGENT][NEUTRAL] Yes, I can help you with that, and you will use my name that I gave you along with today's date as each call reference number. Also, [PII], any information that is provided today will be a verification of benefits and not a guarantee of payment. And lastly, if we do have the claims on file and you need a copy of the explanation of benefits, once you have the claim number, you can print those from our portal yourself by going to [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And what is your first patient's policy number?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] 01841596 M as in Mike, L as in Lima, number 7.
[AGENT][POSITIVE] Thank you. One moment.
[AGENT][NEUTRAL] And what is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII] and date of birth is [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And the date of service and total bill amount for him?
[CUSTOMER][NEUTRAL] [PII] with the bill amount $444 even.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] And you said the billed amount is 444. Is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, so we do not have a claim on file for him for that data service and total bill amount.
[AGENT][NEUTRAL] Because this is a supplemental policy.
[CUSTOMER][NEUTRAL] OK, may I know, ma'am?
[AGENT][NEUTRAL] We will also have to have a copy of the primary insurance company's explanation of benefits along with the claim for review.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. May I get the member effective and the dates, please?
[AGENT][NEUTRAL] Effective date is [PII].
[AGENT][NEUTRAL] And termination date is [PII].
[CUSTOMER][NEUTRAL] OK. May I get the payer ID?
[AGENT][NEUTRAL] 60801.
[CUSTOMER][NEUTRAL] OK. May I get the mailing address?
[AGENT][NEUTRAL] The same as claims it's PO I mean, do you not have the claims mailing address?
[CUSTOMER][NEUTRAL] Yes, it is. I just want to verify this [PII].
[CUSTOMER][NEUTRAL] [PII]. Am I right?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][POSITIVE] OK, thank you so much. May I know the timely filing limit to submit the claim?
[AGENT][POSITIVE] You're welcome.
[AGENT][NEGATIVE] There is no timely filing limit?
[CUSTOMER][POSITIVE] OK, thank you so much. And I have one more member. Are you ready for the next member details?
[AGENT][NEUTRAL] No, I'm not yet. One moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and the next member's policy number?
[CUSTOMER][NEUTRAL] 02344566
[AGENT][POSITIVE] Thank you. One moment.
[AGENT][NEUTRAL] And your patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII], and date of birth is [PII].
[AGENT][POSITIVE] Thank you. The data service and total bill amount.
[CUSTOMER][NEUTRAL] [PII] with the billed amount $336 even.
[AGENT][NEUTRAL] 336, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, and there is no claim on file for this member for that data service.
[AGENT][NEUTRAL] We will also have to have a copy of the.
[CUSTOMER][NEUTRAL] OK. May I know member effective and term date?
[AGENT][NEUTRAL] Yes, first, we will also have to have a copy of the primary insurance company's explanation of benefits along with the claims.
[CUSTOMER][NEUTRAL] Uh, sure.
[AGENT][NEUTRAL] The policy effective date is [PII], and there is no term date. It is still active.
[CUSTOMER][POSITIVE] OK, thank you so much. And the mailing address and the payer ID and there is no TFL that's all the same, right?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] OK. If you don't mind, could you please spell your name once again?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Initial, please.
[AGENT][NEUTRAL] S
[CUSTOMER][POSITIVE] OK, [PII]. Thank you so much. It was nice talking to you. Have a nice day. Stay safe. Bye for now.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] No. OK, [PII], well.
[AGENT][POSITIVE] Well, thank you for calling APL and I hope you have a nice day as well and thank you again for calling.