AccountId: 011433970860
ContactId: f284a77a-14ce-495b-81ac-585e51e25bcc
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 634169 ms
Total Talk Time (AGENT): 158531 ms
Total Talk Time (CUSTOMER): 253848 ms
Interruptions: 4
Overall Sentiment: AGENT=0.1, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/06/f284a77a-14ce-495b-81ac-585e51e25bcc_20250206T18:14_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. Good afternoon. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Hi, good afternoon. My name is [PII] calling from provider's office.
[AGENT][NEUTRAL] OK, and how may I assist you today, Mister [PII]?
[CUSTOMER][NEUTRAL] I need assistance on claims, on the medical claims, uh, which we submitted. I was just, I was transferred to 90-degree benefits who stated that I need to get connected with American Public Life in order to get the update on this medical claims.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, I can check and see if we got him, Mr. [PII], and may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] I can.
[CUSTOMER][NEUTRAL] Sure. Uh it's [PII]. It's a direct line.
[AGENT][NEUTRAL] OK. And where are you calling from, Mr. [PII]?
[CUSTOMER][NEUTRAL] Athens area Urology.
[AGENT][NEUTRAL] OK. And what is the first policy number?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK. The policy number is gonna be uh D as in Delta 46306205.
[AGENT][NEUTRAL] We cannot use the same number as IMA. Do you have another policy? It's gonna start with a 0 followed by 7 digits. That's gonna be our number.
[CUSTOMER][NEGATIVE] We cannot use
[CUSTOMER][NEUTRAL] Do you have another policy with a 07 digits.
[CUSTOMER][NEUTRAL] Allow me a moment.
[CUSTOMER][NEUTRAL] OK. Would that be fine if I provide you the member's name and the date of birth?
[AGENT][NEUTRAL] Uh yes, go ahead with the spell the last name.
[CUSTOMER][NEUTRAL] Sure. The member's first name is gonna be [PII]'s [PII].
[AGENT][NEUTRAL] What's the spelling of the last name?
[CUSTOMER][NEUTRAL] The last name gonna be [PII].
[CUSTOMER][NEUTRAL] Yes. The last name is gonna be [PII] [PII].
[AGENT][NEUTRAL] OK, thank you. One moment.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Hm
[AGENT][NEUTRAL] OK, what is the date of birth for Miss [PII]?
[CUSTOMER][NEUTRAL] The date of birth
[CUSTOMER][NEUTRAL] Uh, it's [PII].
[AGENT][NEUTRAL] OK, may I have the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] Sure. The date of service is gonna be [PII].
[AGENT][NEUTRAL] OK. And how much is the total charge?
[CUSTOMER][NEUTRAL] Uh, it's gonna be $365 even.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And for future you can check the status line on our website at [PII].
[CUSTOMER][NEUTRAL] OK can you can check on the.
[AGENT][NEUTRAL] And you said the total charge was 365?
[CUSTOMER][POSITIVE] That's right.
[AGENT][NEUTRAL] What is the procedure code?
[CUSTOMER][NEUTRAL] It's 99254.
[AGENT][NEGATIVE] Mm yeah that comes no fine.
[CUSTOMER][NEGATIVE] Pardon, I didn't get you.
[AGENT][NEUTRAL] The claim is not on file?
[CUSTOMER][NEUTRAL] OK. Uh, is that, ma'am, uh, what is, uh, the
[CUSTOMER][NEUTRAL] Electronic payer ID in order to submit the claim.
[AGENT][NEUTRAL] OK, for this one, let me see if we have one.
[AGENT][NEUTRAL] OK, the electronic payer ID is 64556.
[CUSTOMER][NEUTRAL] And the ID.
[CUSTOMER][NEUTRAL] OK. Is there any possible way of fax or the mailing address?
[AGENT][NEUTRAL] I can give you a mailing address. There's no fax number. Uh, the mailing address is IMA and that's [PII].
[CUSTOMER][NEUTRAL] OK. Uh, as is, uh, in order to submit through paper and through the electronic pay ID as you provided, uh, what is the timely filing in order to submit the first claims?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Uh, we don't have timely filing limits.
[CUSTOMER][NEUTRAL] OK. Uh, as the member, is the member active?
[CUSTOMER][NEUTRAL] For the date of service.
[AGENT][NEUTRAL] Um, let me get the effective date for you. One moment.
[AGENT][NEUTRAL] OK, we have an effective date of [PII] and it is showing active at the moment.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII] till active at the moment. OK. And one more thing I want to have a confirmation with you. I have uh still 5 more claims for this particular member for different date of service. Uh, is there no claims available for this member?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I have checked the date of service.
[CUSTOMER][NEUTRAL] Or should I provide you each and every date of service? Oh, sure.
[AGENT][NEUTRAL] Correct, yeah, we can only check by date of service. Mhm.
[CUSTOMER][NEUTRAL] OK. Let me provide you the next one. It's [PII] for bill amount $1,335 even.
[AGENT][NEUTRAL] Mr.
[AGENT][NEUTRAL] What is the procedure code on this one?
[CUSTOMER][NEUTRAL] What
[CUSTOMER][NEUTRAL] It's 52353.
[AGENT][NEUTRAL] We don't have that claim on file.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK. Shall we go ahead for the next claim?
[AGENT][NEUTRAL] Mhm. All right.
[CUSTOMER][NEUTRAL] It's November 5 of [PII] for bill amount, $664 even.
[AGENT][NEUTRAL] You said how much was it for? 600?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] 64.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me check on this one.
[AGENT][NEUTRAL] I have to pull the paperwork on this 11 moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I miss to get your name at the beginning. Uh, could you please help me out with your name, meanwhile?
[AGENT][NEUTRAL] Sure, that's [PII], last initial [PII].
[CUSTOMER][NEUTRAL] And that's [PII].
[CUSTOMER][NEUTRAL] OK, so.
[CUSTOMER][NEUTRAL] Because th[PII], all these 6 claims were submitted through your mailing address which you just provided me.
[CUSTOMER][NEGATIVE] But unfortunately, it's a new claim on file as I'm verifying out.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Mm mm.
[AGENT][NEUTRAL] Yeah, this one is not on file either.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK. Shall we go ahead for the next claim, sir?
[AGENT][NEUTRAL] OK, go ahead.
[CUSTOMER][NEUTRAL] Uh, it's for [PII] for built amount $359 even.
[AGENT][NEUTRAL] I don't have a claim for [PII].
[CUSTOMER][NEUTRAL] I don't have a claim for [PII], that's right.
[CUSTOMER][NEUTRAL] OK. Shall we go ahead for the next claim?
[AGENT][NEUTRAL] OK, what's the next day of service?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] At the date of service is gonna be [PII] for bill amount $1,695 even.
[AGENT][NEUTRAL] No claims on file for [PII].
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] OK. Uh, here is the last date of service, sir. Uh, it's [PII] for bill amount $1050 even.
[AGENT][NEUTRAL] There's no claims on file for [PII].
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] OK. So thank you very much for your assistance on this. So. At the beginning, you provided me one of the website. Could you please help me out with the website again?
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] It's gonna be [PII].
[CUSTOMER][POSITIVE] It's gonna be secured.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mm.
[CUSTOMER][POSITIVE] OK. Thank you very much, sir, for your assistance. May I have a reference number for this call?
[AGENT][NEUTRAL] We don't have reference numbers, you can use my name in today's date if you will, Mister [PII].
[CUSTOMER][NEUTRAL] I
[CUSTOMER][POSITIVE] OK. Thank you very much, So, for your assistance on this. Have a wonderful day. Bye for now.
[AGENT][POSITIVE] You're welcome and you also sir and thank you for calling APO bye bye.