AccountId: 011433970860
ContactId: f7cf465d-e7b5-4c89-8e64-7f087af0fa70
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 274880 ms
Total Talk Time (AGENT): 111202 ms
Total Talk Time (CUSTOMER): 91647 ms
Interruptions: 6
Overall Sentiment: AGENT=-0.2, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/14/f7cf465d-e7b5-4c89-8e64-7f087af0fa70_20250314T17:51_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII]. I'm calling because of the provider checking on the claim status and my last name initial is [PII].
[AGENT][NEUTRAL] OK, I could check on a claim for you. Uh, [PII], can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And then do you have that policy number?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] The policy number is 107.
[CUSTOMER][NEUTRAL] 2006.
[AGENT][NEUTRAL] OK and uh what was the name and date of birth for the patient, please?
[CUSTOMER][NEUTRAL] [PII], and the patient, date of birth is [PII].
[AGENT][NEUTRAL] Perfect, thank you for verifying that [PII] uh what was the date of service for this claim?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Under the total charge amount uh.
[CUSTOMER][NEUTRAL] $614 even.
[AGENT][NEUTRAL] OK, and that was [PII] correct?
[CUSTOMER][POSITIVE] Yeah, that's right.
[AGENT][NEUTRAL] OK, so I will let you know [PII], this policy terminated [PII], um, but I will still check to see if we received this claim. Give me just a moment.
[AGENT][NEUTRAL] Uh, what was the name of this provider? I'm sorry?
[CUSTOMER][NEUTRAL] The policy terminated on [PII].
[CUSTOMER][NEUTRAL] Terminated on [PII], right?
[AGENT][NEUTRAL] No, [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And what was the name of the provider's office this was with?
[CUSTOMER][NEUTRAL] But the provider name is urologist.
[CUSTOMER][NEUTRAL] OK. Urology of Saint Louis.
[AGENT][NEUTRAL] OK, so I did find one claim for that date of service for the amount of $300 but that's the only claim we have on file for this date of service, and of course we were unable to make a benefit or pay a benefit as the services were rendered after coverage was terminated.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Claim not on file, right?
[AGENT][NEGATIVE] Not for this amount, no.
[CUSTOMER][NEUTRAL] OK, actually for this.
[CUSTOMER][NEUTRAL] Another data service also for the same patient that is [PII] and the total charge amount is $100 even.
[AGENT][NEUTRAL] No, the only claim I have on file for that date of service, [PII], um, from Urology of Saint Louis is for $300.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and may I know the payer ID?
[AGENT][NEUTRAL] Your ID is 60801.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] May I know the patient effective date?
[AGENT][NEUTRAL] The effective date for this policy was [PII].
[CUSTOMER][POSITIVE] He effectively.
[CUSTOMER][NEUTRAL] Term date is [PII].
[AGENT][NEUTRAL] [PII], correct, yes.
[CUSTOMER][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK. May I know the timely file limit?
[AGENT][NEGATIVE] Oh, there's no timely filing limit.
[CUSTOMER][NEUTRAL] May I know the mailing address?
[AGENT][NEUTRAL] That is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And that is in [PII].
[AGENT][NEUTRAL] Zip code is [PII].
[CUSTOMER][NEUTRAL] It.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah, OK.
[CUSTOMER][NEUTRAL] Just a moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Can
[CUSTOMER][NEUTRAL] the
[CUSTOMER][NEUTRAL] OK. May I know the call reference number?
[AGENT][NEUTRAL] Reference number would just be my first name, last initial, and today's date. Um so my name is spelled [PII] Was there anything else I could help you with, [PII]?
[CUSTOMER][POSITIVE] No, that's all about my side. Thank you so much. Have a great day and bye for now.
[AGENT][POSITIVE] OK, yeah, thanks for calling as well. You too. Thanks. Bye bye.
[CUSTOMER][NEUTRAL] OK.