AccountId: 011433970860
ContactId: f6ccc9af-5306-425d-a98c-defea439aaef
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 277339 ms
Total Talk Time (AGENT): 117364 ms
Total Talk Time (CUSTOMER): 88644 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/14/f6ccc9af-5306-425d-a98c-defea439aaef_20250114T16:50_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Good morning. I'm sorry, who am I speaking with?
[AGENT][NEUTRAL] This is [PII].
[CUSTOMER][NEUTRAL] So good morning. My name is [PII]. I need to um check a claim status please. I'm trying to see if you guys have ever received this claim.
[AGENT][NEUTRAL] OK, sure. I can assist you with claims and this is your personal policy you're calling from provider's office.
[CUSTOMER][NEUTRAL] No, I'm calling from the hospital.
[AGENT][NEUTRAL] OK, and alright, and may I have a callback number just in case we get disconnected, Miss [PII].
[CUSTOMER][NEUTRAL] Facility.
[CUSTOMER][NEUTRAL] Yes, absolutely, that phone number is [PII] and that.
[AGENT][NEUTRAL] Mm
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] That's enough.
[AGENT][NEUTRAL] OK, and may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Absolutely, the number is 01992301 and so may I have the first initial of your last name?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] You're welcome. And I need the name and date of birth of the member.
[CUSTOMER][NEUTRAL] The patient's name is [PII] and I have the date of birth is [PII].
[AGENT][NEUTRAL] OK perfect thank you. And what is the date of service and the amount the claim?
[CUSTOMER][NEUTRAL] The data service that I'm inquiring about is um [PII]. The total charge billed amount is $2,106.67.
[AGENT][NEUTRAL] That was $50.67.
[CUSTOMER][NEUTRAL] $22,106.67.
[AGENT][NEUTRAL] Let.
[AGENT][NEUTRAL] OK, thank you. OK, let me see if I can find this claim.
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] And Miss [PII] for future, you can check claim status online through our website at [PII] and that's just optional. Um and so you say it was [PII].
[AGENT][NEUTRAL] I don't have a claim for [PII] for this number.
[CUSTOMER][NEUTRAL] OK, does the member have active coverage for that data service?
[AGENT][NEUTRAL] OK, let me give you the effective date of the policy.
[AGENT][NEUTRAL] OK. Effective date for Arlita is um see [PII]. The policy terminated on [PII].
[CUSTOMER][NEUTRAL] So what's that what's the timely filing for claims?
[AGENT][NEGATIVE] We don't have timely filing limits.
[CUSTOMER][NEUTRAL] Um, do you accept claims electronically?
[AGENT][NEUTRAL] Uh, for this one, yes, we do. Mhm, let me see which one is.
[CUSTOMER][NEUTRAL] May I have a payer ID?
[AGENT][NEUTRAL] Mhm. Let me go ahead and get the payer ID for this type of product. OK, the payer ID on this one is 64556.
[CUSTOMER][NEUTRAL] No timely filing limit. OK, and may I have a reference number for the call?
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] We don't have reference numbers you can use my name in today's date.
[CUSTOMER][NEUTRAL] OK, um, what else was I gonna ask you? So there's no time. Can this be faxed in or does this just need to be mailed in or sent electronically?
[AGENT][NEUTRAL] Um, it goes to IMA for repricing before it gets to us, so it has to be either mail or um an electronic. We don't have a fax number for IMA.
[CUSTOMER][NEUTRAL] You said it goes to I as in ice, M as in Mary, A as in apple for pricing?
[AGENT][POSITIVE] Yes, correct.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] Um, OK, alright, well thank you so much you have a great day.
[AGENT][NEUTRAL] You as well, is there anything else I may help you with today, Miss [PII]?
[CUSTOMER][NEUTRAL] That.
[AGENT][POSITIVE] OK, thank you for calling APO. Have a good afternoon. You're welcome.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Bye bye.