AccountId: 011433970860
ContactId: f3eba85e-3033-4346-8c9d-1f81701ebf0a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 274160 ms
Total Talk Time (AGENT): 107148 ms
Total Talk Time (CUSTOMER): 86546 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/29/f3eba85e-3033-4346-8c9d-1f81701ebf0a_20250529T15:35_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII] from Provada's office, checking on the lamps.
[AGENT][POSITIVE] OK, well, I'll be more than happy to assist you with the claim status, and [PII], how many claims do you have in total today?
[CUSTOMER][NEUTRAL] Um, I do have only one client right now.
[AGENT][NEUTRAL] OK, may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Mm yeah, for the contact number that is [PII].
[AGENT][NEUTRAL] Thank you and the member's policy number?
[CUSTOMER][NEUTRAL] Um, for the policy number.
[CUSTOMER][NEUTRAL] Just a moment.
[CUSTOMER][NEUTRAL] 1290525 M as in Mike, L as in Lima, number 7.
[AGENT][NEUTRAL] Thank you and can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Mm. First name, it's [PII]. And the last name is [PII]. And the date of birth, that is [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And may I have the date of service and the total bills for the claim?
[CUSTOMER][NEUTRAL] It's [PII]. Uh, for the charges, it's $802 even.
[CUSTOMER][NEUTRAL] Primary process as deductible for $366.86.
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Alright, so this um claim was processed under the active policy number which is 185.
[AGENT][NEUTRAL] 0627.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] This policy has been active since um [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And you said the total for this claim is $802?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] Alright, so we only received 2 claims for that data service.
[AGENT][NEUTRAL] The first one, hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And neither of the claims are for, are for your total bill. What's the name of the provider on file, or that would be on the claim?
[CUSTOMER][NEUTRAL] Um, it does JMT specialty physicians.
[AGENT][NEUTRAL] Yeah, and there are two different um providers. So we don't have a claim on file from your provider or with your total bills, but the policy was active, so you can file the claim if you'd like.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, what's the timely filing limit?
[AGENT][NEUTRAL] There's no timely filing as long as the policy was active on the data service, you can file at any time.
[CUSTOMER][NEUTRAL] OK, can you please provide me the payer ID and the PO box address?
[AGENT][NEUTRAL] Sure, I pay ID is 60801.
[CUSTOMER][NEUTRAL] Mhm mhm.
[AGENT][NEUTRAL] And our mailing address is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The zip code is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK, [PII], thank you so much. Can I get the call reference number, please?
[AGENT][NEUTRAL] So there's no call reference number, but you can use my name and today's date. The first initial to my last name is [PII].
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][POSITIVE] Thank you so much, [PII]. Have a great day. Bye-bye. Thanks for that.
[AGENT][POSITIVE] You're welcome. Was there anything else I can assist you with today, [PII]?
[CUSTOMER][NEUTRAL] Mm, no, thanks for asking.
[AGENT][POSITIVE] All right, thanks for calling APL. Bye-bye.
[CUSTOMER][NEUTRAL] Bye bye.