AccountId: 011433970860
ContactId: f5018c42-d8e2-47a0-b3cc-b7efb2c673d4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 530820 ms
Total Talk Time (AGENT): 178829 ms
Total Talk Time (CUSTOMER): 128883 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/22/f5018c42-d8e2-47a0-b3cc-b7efb2c673d4_20250522T20:07_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] calling from provider's office to check on the claims.
[AGENT][NEUTRAL] OK, did you say your name is [PII] or [PII]?
[CUSTOMER][NEUTRAL] [PII]. My initial is [PII].
[AGENT][NEUTRAL] Thank you. And you are needing to check claim status, is that correct, [PII]?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Can I have your name as well?
[AGENT][NEUTRAL] Yes, I can help you with, again, my name is [PII].
[AGENT][NEUTRAL] And [PII], what is your callback number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And how many claims, [PII], do you have to check status on?
[CUSTOMER][NEUTRAL] I have 2 claims for 2 different patients.
[AGENT][NEUTRAL] OK, and you, [PII], you will use my name along with today's date as each of your call reference numbers. Also, any information that I provide for you on the claims will be a verification of benefits and not a guarantee of payment.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] And lastly, if we do have the claims on file once you have the claim number if you need a copy of the explanation of benefits you can print that from our portal by going to secured.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] OK. All right. Thank you for that information.
[AGENT][NEUTRAL] You're welcome. And what is your first patient's policy number, [PII]?
[CUSTOMER][NEUTRAL] I have 0169.
[CUSTOMER][NEUTRAL] 4166.
[AGENT][POSITIVE] Thank you, one moment.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] And what is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] It is [PII].
[CUSTOMER][NEUTRAL] Mac uh uh M class.
[AGENT][NEUTRAL] And her date of birth?
[CUSTOMER][NEUTRAL] Date of birth is March, yeah, [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] Data service and total bill amount.
[CUSTOMER][NEUTRAL] So, I have uh 618 of 2024. Bill amount is $238.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, so [PII] on this policy there is no claim on file for that data service but this policy was not active for your data service.
[AGENT][NEUTRAL] This policy was effective at [PII].
[CUSTOMER][NEUTRAL] And uh can I
[AGENT][NEUTRAL] And it turned on [PII].
[AGENT][NEUTRAL] Let me see if there is another policy. And there is, you have a an old policy number. So just a moment for me to get the other policy information pulled up.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] OK, sure.
[AGENT][NEUTRAL] So the correct policy number that you should have is 01935873.
[AGENT][NEUTRAL] And this policy is active, effective [PII].
[CUSTOMER][NEUTRAL] And still current.
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] Uh, just give me a second.
[CUSTOMER][NEUTRAL] All right then, uh, so I just want to double check the mailing address that we used previously, that is [PII]. Yeah, go ahead.
[AGENT][NEUTRAL] Um
[AGENT][NEUTRAL] Go ahead. Yes, because we do not, I even looked on the current AA policy and there is no claim on file.
[CUSTOMER][NEUTRAL] Yeah, uh, I just, I also want to verify the mailing address because I'm gonna submit this claim again. [PII]. It is [PII] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] That is correct.
[AGENT][NEUTRAL] And also, [PII].
[CUSTOMER][POSITIVE] OK, then. Thank you so much, sir.
[AGENT][NEUTRAL] Yes, sir. And also you will need to send us a copy of the primary insurance company's explanation of benefits along with the claim for review. We do have to have that.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Yes, I do have that information here. Thank you.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and do you need any other information on this number?
[CUSTOMER][NEUTRAL] Uh, that's all for this member. We'll move on to the next member.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, and the next member's policy number, please?
[CUSTOMER][NEUTRAL] Sure. One moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I have
[CUSTOMER][NEUTRAL] Uh just a second.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I have 01877135 M as in Mike.
[CUSTOMER][NEUTRAL] L as in Lima, 8.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] And your patient's name and date of birth?
[CUSTOMER][NEUTRAL] That is uh [PII], [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And what is the data service and total build amount please?
[CUSTOMER][NEUTRAL] Uh, [PII]. The amount is $394 394 dollars.
[AGENT][POSITIVE] Thank you, one moment.
[AGENT][NEUTRAL] And you said [PII] of [PII] for $394. Is that correct?
[CUSTOMER][POSITIVE] That's correct.
[AGENT][NEUTRAL] OK, there is no claim on file for that data service and that bill out.
[CUSTOMER][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Can I have this patient's effective date?
[AGENT][NEUTRAL] The policy is active and the effective date on the plan is [PII].
[CUSTOMER][NEUTRAL] Uh, may I, may I also know the timely filing to submit the claim?
[AGENT][NEUTRAL] There's no timely filing limit?
[CUSTOMER][POSITIVE] Thank you so much for that information. That's all I had for today. That's the two claims. Thank you so much, [PII]. You have a great day. Bye-bye.
[AGENT][NEUTRAL] OK, [PII].
[AGENT][POSITIVE] Well, I hope you have a great day too, and thank you again for calling APL.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Bye-bye.