AccountId: 011433970860
ContactId: ee5efb74-6920-4594-a6b7-13b3cca2faaa
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 382290 ms
Total Talk Time (AGENT): 118930 ms
Total Talk Time (CUSTOMER): 218731 ms
Interruptions: 5
Overall Sentiment: AGENT=0.6, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/20/ee5efb74-6920-4594-a6b7-13b3cca2faaa_20250620T15:07_UTC.wav
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[AGENT][NEUTRAL] Calling APL, this is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Yes, uh my name is [PII]. Um, I am calling from a provider's office and um calling to check on the status of a claim please and by the way, how do you spell your name?
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII], can I have a callback number for you?
[CUSTOMER][NEUTRAL] OK. All right.
[CUSTOMER][NEUTRAL] Yeah sure it's [PII].
[AGENT][NEUTRAL] Thank you and what's the policy number of the member that you're calling to check the status of a claim for today?
[CUSTOMER][NEUTRAL] Yeah, that would be 02286564 M like Mary L like Lima 7.
[AGENT][NEUTRAL] Could you verify the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Patient's name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] And [PII], you're calling to check the status of a claim for what date of service?
[CUSTOMER][NEUTRAL] It was from [PII].
[AGENT][NEUTRAL] So this is for a facility charge?
[CUSTOMER][NEUTRAL] It is, yeah, and then they had American public life as a secondary policy.
[AGENT][NEUTRAL] What is the
[AGENT][NEUTRAL] Do you have a procedure code or is there a?
[AGENT][NEUTRAL] Bill amount
[CUSTOMER][NEUTRAL] Procedure
[CUSTOMER][NEUTRAL] Let me see, about a bill amount I can tell you, yeah, well, well, before they build the, the, uh, primary insurance, the bill amount was $114,829.90 and after the adjustments and payments were made, the amount that we billed American public life was $2,875.92.
[AGENT][NEUTRAL] Is there a procedure code or was it a facility claim?
[CUSTOMER][NEUTRAL] Well, let me see, let me see, procedure code, well, it's definitely, it's, it's definitely, it's definitely a facility claim now I have a, I can give you a revenue code if that helps.
[AGENT][NEUTRAL] The professionals or?
[AGENT][NEUTRAL] I'm trying to find a plane. You said [PII].
[CUSTOMER][NEUTRAL] Yeah, because I have a few
[CUSTOMER][NEUTRAL] Yeah, I have a um I have a few revenue codes. It was in the service date again was, um, [PII].
[CUSTOMER][NEUTRAL] You know it was [PII].
[AGENT][NEUTRAL] So I'm not showing the claim on file. Did you guys submit a claim here?
[CUSTOMER][POSITIVE] Oh absolutely yeah that's why I'm calling you we submit. I could tell you when we submitted it hang on um.
[CUSTOMER][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] I see. Hang on a minute.
[CUSTOMER][NEUTRAL] That's
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] May on [PII] of this year, the claim was sent.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Right, that is correct, yes.
[AGENT][NEUTRAL] I'm not showing the claim on file for that data service. I'm not showing the claim on file that we received the last time we received the claim for this member was [PII].
[CUSTOMER][NEUTRAL] Well let me.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII], well, hm, was that the same claim? Is it?
[AGENT][NEUTRAL] No, it's not we don't have a facility claim, we only have professional claims, professional fees.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] OK, so is it, in other words, so it was, so it was a doctor's bill that you had on [PII], is that, is that what you, what you're saying?
[AGENT][NEUTRAL] Well, I can't tell you what type of claim it was but I know for those we only have, we don't have that one.
[CUSTOMER][NEUTRAL] OK, OK, OK, OK, OK, OK, OK, it wasn't bottom right, the bottom line it wasn't this one. OK, let me ask you, um.
[CUSTOMER][NEUTRAL] Is there, uh, I know some, some, some insurance companies they get a claim and it takes them a while to upload it. Is it possible that you might have the claim there and it just hasn't been uploaded yet? Is there like a delay in uploading claims from the time you receive them?
[AGENT][NEUTRAL] No, that was in May. It's [PII]. It would have been uploaded.
[AGENT][NEUTRAL] Once it was received.
[CUSTOMER][NEUTRAL] How long does it usually take to, uh, how long does it usually take to upload?
[AGENT][NEUTRAL] 24 hours depending on how you submitted the claim, I'm not sure how you submitted it. Did you send it by mail or did you send it by fax or did you send it by?
[CUSTOMER][POSITIVE] Well, that's pretty
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] we typically, we typically send them by mail.
[AGENT][NEUTRAL] Electronic payer ID?
[AGENT][NEUTRAL] Could you verify the mailing address that you sent it to, [PII]?
[CUSTOMER][NEUTRAL] We typically send it by mail.
[CUSTOMER][NEUTRAL] Uh, let me see, let's see.
[CUSTOMER][NEUTRAL] It says we're supposed to mail the [PII].
[AGENT][NEUTRAL] Right, that is the correct address that.
[AGENT][NEUTRAL] You're supposed to send it to, but was it? I'm not sure if it was actually sent there or not, however, we don't have a claim on file.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] It was, it was, yeah, yeah, yeah, we don't typically fax. We usually mail them because usually there's a lot of pages and especially the original man this bill was so large it would probably been a ton of pages we would have never faxed, we would never faxed 50 or 100 pages. There's no way because we, we know that it just it it they get mixed up but when they, when they received a fax machine.
[CUSTOMER][NEUTRAL] Alright, well, I'm gonna have to check on, on, on uh on our end here, um, but you don't have the claim alright I'll.
[AGENT][NEUTRAL] We have a payer ID. Would you like a payer ID to electronically file it?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Um, yeah, yeah, yeah, what would, what would that be, please?
[AGENT][NEUTRAL] 60801.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I see.
[CUSTOMER][NEUTRAL] I'm sorry, can you repeat that? Could you repeat that please?
[AGENT][NEUTRAL] 60801.
[CUSTOMER][NEUTRAL] 60801 is the payer ID that's that is that an EFT number?
[AGENT][POSITIVE] Yes, that's correct.
[AGENT][NEUTRAL] That's the payer ID, the electronic payer ID.
[CUSTOMER][NEUTRAL] It's an EFT number.
[CUSTOMER][NEUTRAL] OK, electronic payer ID. OK, alright. Oh, alright, you know what, I'm gonna check it on our end here. I will have to resend it. Is there a reference number on this call, please?
[AGENT][NEUTRAL] We don't provide those. however, you can use my name in today's date as a um as a reference.
[CUSTOMER][NEUTRAL] OK, fair enough. OK. And you said your name that's [PII]?
[AGENT][POSITIVE] Yes, that is correct.
[CUSTOMER][POSITIVE] OK, very good, [PII]. I thank you for your time. Have a nice day. Thanks.
[AGENT][POSITIVE] You're welcome. Thanks for calling APL. You have a great one as well, [PII]. Goodbye.
[CUSTOMER][POSITIVE] Thanks take care bye.