AccountId: 011433970860
ContactId: ef56dec5-7bf6-4bcf-bac9-09055785dc31
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 490200 ms
Total Talk Time (AGENT): 123293 ms
Total Talk Time (CUSTOMER): 164575 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=-0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/26/ef56dec5-7bf6-4bcf-bac9-09055785dc31_20250626T15:09_UTC.wav
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[AGENT][NEUTRAL] Calling ACL. This is [PII]. How can I help you?
[CUSTOMER][POSITIVE] Hi, good morning.
[CUSTOMER][NEUTRAL] I'm calling to check on the claim status.
[AGENT][NEUTRAL] OK, I can help you with claim status. May I please get your name, your callback number, and the name of the facility you're calling from?
[CUSTOMER][NEUTRAL] Yeah, sure, so my name is [PII] and my callback number, it's a moment.
[CUSTOMER][NEUTRAL] So my callback number is [PII].
[CUSTOMER][NEUTRAL] And the name of the facility it's.
[CUSTOMER][NEUTRAL] Live it Medical and we're doing business as advanced dermatology.
[AGENT][NEUTRAL] OK, thank you. And then what is the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Sure. So the patient's name is [PII].
[CUSTOMER][NEUTRAL] And date of birth is [PII] and his policy number it's 02033166 M as in Mary, L as in Lima 7.
[AGENT][NEUTRAL] OK, and let me repeat it. 0213346 ML 7?
[CUSTOMER][NEUTRAL] No, 02033166 ML 7.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, let me look that up real quick.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, sure.
[AGENT][NEUTRAL] OK and then what is [PII]'s date of service and charge amount?
[CUSTOMER][NEUTRAL] Sure, so I'm checking on Tuesday the service for him. So I'm checking for [PII] for $644 and then the other day of services are gonna be.
[CUSTOMER][NEUTRAL] [PII] of this year.
[CUSTOMER][NEUTRAL] For $446.
[AGENT][NEUTRAL] OK, on the [PII], what is the charge amount after the primary paid their part?
[CUSTOMER][NEUTRAL] Do you mean the amount that we're expecting to receive?
[AGENT][NEUTRAL] Right, the balance after the primary insurance paid their part?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] 50 and then for the uh [PII]?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The same, the amount.
[CUSTOMER][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Yeah, sure, it's gonna be 50 as well.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right, I'm gonna put you on a brief hold while I look up these claims for you and I will be right back, Ms. [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK sure thank you.
[AGENT][POSITIVE] Thank you, ma'am.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK, thank you for holding for me, [PII]. So looking on the date of service of [PII] and and [PII], I do not find a claim on file, although the claim, uh, the policy number that you gave me to begin with 02033166 was lapsed in the year of [PII].
[AGENT][NEUTRAL] And so the insured has another policy after that lapse date and let me give you that policy number.
[CUSTOMER][NEUTRAL] OK, sure.
[AGENT][NEUTRAL] It's 234-064-0. The effective date is [PII], and then the policy did terminate on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And just to confirm, you said the new member ID would have been 234-0640. There was no letters in it.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK, so in that case I could just have the claims rebuild with that new member ID number, right?
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] OK, uh, what's normally the timely filing time frame for you guys? It's one year?
[AGENT][NEUTRAL] We don't have, we don't have one. No, ma'am. We don't have one at all.
[CUSTOMER][NEUTRAL] OK, alrighty, let me just check on my list to see if that was the only patient. One moment.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][POSITIVE] Mhm, OK, yeah, that was it. So thank you so much for your help. uh, what was your name again?
[AGENT][NEUTRAL] My name is [PII] Y.
[CUSTOMER][NEUTRAL] Thank you. Is there a reference number?
[AGENT][NEUTRAL] Yes, ma'am. You can use my name and today's date.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Alrighty well thank you so much for your help and you have a great day, OK?
[AGENT][POSITIVE] You too. Thank you for calling APL. You have a wonderful day also. Bye-bye, Ms. [PII].
[CUSTOMER][NEUTRAL] Same to you bye bye.