AccountId: 011433970860
ContactId: fe760893-0c03-4974-955c-59976f40bd2d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1950849 ms
Total Talk Time (AGENT): 303515 ms
Total Talk Time (CUSTOMER): 561249 ms
Interruptions: 0
Overall Sentiment: AGENT=0.1, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/27/fe760893-0c03-4974-955c-59976f40bd2d_20250527T19:48_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good afternoon. Thanks for calling APL. This is. May I help you?
[CUSTOMER][NEUTRAL] Yes, my first name is uh [PII]. My last name is [PII] calling you from the provider's office looking for claim status. And could you please repeat again your name, please?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Sure, it's [PII] last initial [PII] and your name is again?
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] OK, and what is the policy number?
[CUSTOMER][NEUTRAL] Uh, yes, the patient's ID is, uh, OK, the patient I just start with uh D as in delta, uh, you're not handling, right?
[AGENT][NEUTRAL] It's not one of our policy numbers.
[CUSTOMER][NEUTRAL] OK, uh, so.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] So the next ID is 01991154.
[AGENT][NEUTRAL] OK, and do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] Yes, the call back number is [PII].
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] And verify the patient's name, date of birth.
[CUSTOMER][NEUTRAL] Yeah, the patient's first name is uh [PII], last name is uh [PII]. and the date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you. And what was the date of service and the amount of the charge?
[CUSTOMER][NEUTRAL] Dat of services $725.23 and the total charge is $9,662.75.
[AGENT][NEUTRAL] OK, and the balance after primary?
[CUSTOMER][NEUTRAL] Uh, after primary, uh.
[CUSTOMER][NEUTRAL] $1,644.73.
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] Uh, we have not received that claim. Can you verify the address the claim was submitted to?
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] Uh, is it, uh.
[CUSTOMER][NEUTRAL] [PII], I mean [PII].
[CUSTOMER][NEGATIVE] No, this is not the [PII].
[CUSTOMER][NEUTRAL] [PII], OK, [PII].
[AGENT][NEUTRAL] That is correct. If you'd like, I can give you a fax number if you'd like to fax the claim.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Can I have the memory effectively?
[AGENT][NEUTRAL] Uh, [PII], policy terminated [PII].
[CUSTOMER][NEUTRAL] OK, and the uh timely founding limit?
[AGENT][NEUTRAL] There is none.
[CUSTOMER][POSITIVE] OK, uh, thank you, let's move to the next patient.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] OK, and what is next policy number?
[CUSTOMER][NEUTRAL] Uh, yes, the patient ID is 02287712.
[AGENT][NEUTRAL] Patient's name, date of birth?
[CUSTOMER][NEUTRAL] The patient's uh first name is [PII] and the last name is [PII], and the date of birth is uh [PII].
[AGENT][NEUTRAL] OK, date of service amount of the charge.
[CUSTOMER][NEUTRAL] Uh, December, I'm sorry, [PII], and the total charge is $3,119 even.
[AGENT][NEUTRAL] OK and the balance after primary?
[CUSTOMER][NEUTRAL] Uh, after primary $342.20.
[AGENT][NEUTRAL] Not a moment.
[AGENT][NEUTRAL] I do not show we received that claim and you said the date of service was [PII]?
[CUSTOMER][NEUTRAL] [PII] years. OK, uh, what is the member's effective date and term date?
[AGENT][NEUTRAL] And let me give you the correct policy number when you're ready.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Uh yes, I'm ready.
[AGENT][NEUTRAL] Uh, policy number 2301357.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The effective date was [PII]. Policy terminate [PII].
[CUSTOMER][NEUTRAL] OK, uh, let's move to the next question.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] OK, what is next policy number?
[CUSTOMER][NEUTRAL] 023 07621.
[AGENT][NEUTRAL] Patient's name, date of birth?
[CUSTOMER][NEUTRAL] The patient's first name is uh [PII] and the last name is [PII]. And the date of birth is uh [PII].
[AGENT][NEUTRAL] Data service model of the charge.
[CUSTOMER][NEUTRAL] That services uh [PII] and the total charge is $3,938.75.
[AGENT][NEUTRAL] Balance after primary.
[CUSTOMER][NEUTRAL] Uh primary.
[CUSTOMER][NEUTRAL] $1,239.64.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] And we have not received that claim.
[CUSTOMER][NEUTRAL] OK, uh, can I have the member's effective date and time date?
[AGENT][NEUTRAL] Effective [PII], terminated.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, thank you. Let's move to the next question.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] OK, what is next policy number?
[CUSTOMER][NEUTRAL] 01477436.
[AGENT][NEUTRAL] Patient's name, date of birth?
[CUSTOMER][NEUTRAL] The patient's first name is [PII], last name is [PII], and the date of birth is.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, data service amount of the charge.
[CUSTOMER][NEUTRAL] [PII] and the total charge is $2,971 even.
[AGENT][NEUTRAL] Balance after the primary.
[CUSTOMER][NEUTRAL] Uh, after primary, the balances.
[CUSTOMER][NEUTRAL] 30 $26.35.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] And the name of this provider's office?
[CUSTOMER][NEUTRAL] Uh, this is under, uh.
[CUSTOMER][NEUTRAL] 2
[CUSTOMER][NEUTRAL] So this is on the St. Mary Hospital.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, I've shown in this claim, we paid 28176, and with that payment at max there benefit for the year.
[CUSTOMER][NEUTRAL] 176 2702.
[CUSTOMER][NEUTRAL] So.
[CUSTOMER][NEUTRAL] So are you saying that you paid on this claim or different uh on a different date of service?
[AGENT][NEUTRAL] We paid on this claim in the amount of 28176, and with that payment it matched their benefit for the uh calendar year.
[CUSTOMER][NEUTRAL] And uh how did you make the payment? Is it by check or EFT?
[AGENT][NEUTRAL] Paper check.
[CUSTOMER][NEUTRAL] Uh check number.
[AGENT][NEUTRAL] 204-408-6
[CUSTOMER][NEUTRAL] And the issue date.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII] of this year.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK. And the uh check your date.
[AGENT][NEGATIVE] I don't show that it's cleared.
[CUSTOMER][NEUTRAL] P
[CUSTOMER][NEUTRAL] And and the uh pay to your address.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] 7.
[CUSTOMER][NEUTRAL] OK, and the claim number?
[AGENT][NEUTRAL] 3600595
[CUSTOMER][NEUTRAL] OK. And also, uh, is it possible for you to fax me the EOB?
[AGENT][NEUTRAL] Uh, we do have an online service center where providers can check claim status as well as print out the EOB. That site is at [PII].
[CUSTOMER][NEUTRAL] OK, and also you mentioned that uh the paid amount is 281.76.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] 176 OK and the
[CUSTOMER][NEUTRAL] There is no denial on the claim, right?
[AGENT][POSITIVE] No, since we paid on the claim, there's no denial.
[CUSTOMER][NEUTRAL] OK, uh, let's move to the next question.
[AGENT][NEUTRAL] One moment. How many more patients do you have?
[CUSTOMER][NEUTRAL] Uh, I still have like uh.
[CUSTOMER][NEUTRAL] 7 more claims.
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] 06 more clean.
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] What is the next policy number?
[CUSTOMER][NEUTRAL] 02456419.
[CUSTOMER][NEUTRAL] And this is for the patient's first name, [PII], and the last name is uh [PII].
[AGENT][NEUTRAL] Date of birth?
[CUSTOMER][NEUTRAL] Uh yes, the date of birth is.
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] OK, data service amount of the charge.
[CUSTOMER][NEUTRAL] [PII] and the total charge is $6,801.80.
[AGENT][NEUTRAL] Balance after primary.
[CUSTOMER][NEUTRAL] Uh, the software primary, yes.
[CUSTOMER][NEUTRAL] Uh, $1,666.32.
[AGENT][NEUTRAL] I don't show we've received that claim.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So one.
[CUSTOMER][NEUTRAL] 0
[CUSTOMER][NEUTRAL] OK. So you're saying that you, you didn't see any claims.
[AGENT][NEUTRAL] We have not received a claim for that data service.
[CUSTOMER][NEUTRAL] OK. Can I have the memory effective date?
[AGENT][NEUTRAL] Effective [PII], policy is active.
[CUSTOMER][POSITIVE] Uh, thank you, let's move to the next question.
[AGENT][NEUTRAL] OK, what is that policy number?
[CUSTOMER][NEUTRAL] Uh yes, the patient's ID is.
[CUSTOMER][NEUTRAL] 01884094.
[AGENT][NEUTRAL] Patient's name, date of birth?
[CUSTOMER][NEUTRAL] Date of birth is uh [PII]. And the, I'm sorry, uh date of birth is [PII]. 1st name is uh [PII] and the last name is [PII].
[AGENT][NEUTRAL] I don't show that patient under this policy.
[CUSTOMER][NEUTRAL] Uh, just to make sure the patient's ID is 01884094.
[AGENT][NEUTRAL] OK, patient's name and date of birth again?
[CUSTOMER][NEUTRAL] [PII] last name is [PII].
[CUSTOMER][NEUTRAL] And the date of birth is [PII].
[AGENT][NEUTRAL] OK. Again, I do not show that patient under this policy.
[CUSTOMER][NEUTRAL] How about the first name is uh [PII]
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] You said the patient's name was [PII]?
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Uh, yes, can you hear me?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So, uh.
[CUSTOMER][NEUTRAL] Um, this is.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Let me see 604.
[CUSTOMER][NEUTRAL] Uh, the patients
[CUSTOMER][NEUTRAL] The patient ID 2024389, right?
[AGENT][NEUTRAL] That is not the policy number you gave me.
[CUSTOMER][NEUTRAL] Mm, uh, uh, can you try again with this number? 0, I mean, uh, 2024389.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I show her on this policy. What is the data service amount of the charge?
[CUSTOMER][NEUTRAL] On the services.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, [PII] and the total charges.
[CUSTOMER][NEUTRAL] Uh, $1,277 even.
[AGENT][NEUTRAL] Balance after primary.
[CUSTOMER][NEUTRAL] Uh so primary is uh $672 even.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] And I don't show we received that claim.
[CUSTOMER][NEUTRAL] OK, uh.
[CUSTOMER][NEUTRAL] What is your memory?
[AGENT][NEUTRAL] [PII] policy turn, [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Uh, thank you, let's move to the next patient.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, next policy number.
[CUSTOMER][NEUTRAL] 02435030.
[AGENT][NEUTRAL] Patient's name, date of birth?
[CUSTOMER][NEUTRAL] Uh, the patient's first name is uh [PII]. Last name is [PII], and the date of birth is [PII].
[AGENT][NEUTRAL] Data service, amount of the charge.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Uh, [PII] total charge is 1900.
[CUSTOMER][NEUTRAL] $16 even.
[AGENT][NEUTRAL] Balance after primary.
[CUSTOMER][NEUTRAL] The balance of the primary is $839.41.
[AGENT][NEUTRAL] And what's the name of this provider?
[CUSTOMER][NEUTRAL] Uh, this is under.
[CUSTOMER][NEUTRAL] Memorial Regional Medical Center.
[AGENT][NEUTRAL] And I don't show we received that claim.
[CUSTOMER][NEUTRAL] OK, uh, members effective date.
[AGENT][NEUTRAL] [PII], policy is active.
[CUSTOMER][NEUTRAL] OK, um, let's move to the next question.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] OK, what is next policy number?
[CUSTOMER][NEUTRAL] Uh, yes, the patients ID.
[CUSTOMER][NEUTRAL] The patient's ID is 02441509.
[AGENT][NEUTRAL] Patient's name, date of birth?
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] The first name is uh [PII]. Last name is [PII].
[CUSTOMER][NEUTRAL] And the date of birth is [PII].
[AGENT][NEUTRAL] OK, data service amount of the charge.
[CUSTOMER][NEUTRAL] Uh, [PII] total charge is $5,735 even.
[AGENT][NEUTRAL] And we have not received that claim.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Ms effective date.
[AGENT][NEUTRAL] [PII] and the policy is active.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, let's move to the next patient.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] OK, what is the next policy number?
[CUSTOMER][NEUTRAL] Uh, the ideas.
[CUSTOMER][NEUTRAL] 02493350.
[AGENT][NEUTRAL] Patient's name, date of birth?
[CUSTOMER][NEUTRAL] The date of birth is [PII]. 1st name is [PII], last name is [PII].
[AGENT][NEUTRAL] OK. Date of birth, I'll be um date of service on the chart.
[CUSTOMER][NEUTRAL] [PII] total charge is $21,423.13.
[AGENT][NEUTRAL] Balance after primary.
[CUSTOMER][NEUTRAL] Uh, after the primary $1,883.30.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] And we have not received that claim.
[CUSTOMER][NEUTRAL] I must see if I indeed.
[AGENT][NEUTRAL] Effective [PII], terminated [PII], 25.
[CUSTOMER][NEUTRAL] The first
[CUSTOMER][POSITIVE] Thank you. Let's move to the last patient.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] OK, what is the next policy number?
[CUSTOMER][NEUTRAL] Uh, yes, the patient so the trees.
[CUSTOMER][NEUTRAL] 021-73251.
[AGENT][NEUTRAL] Patient's name, date of birth?
[CUSTOMER][NEUTRAL] The patient's first name is [PII]. Last name is uh [PII].
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][NEUTRAL] OK, data service amount of the charge.
[CUSTOMER][NEUTRAL] Uh, [PII] and the total charge is $940 even.
[AGENT][NEUTRAL] Balance after primary.
[CUSTOMER][NEUTRAL] On this, um, uh, I see American public life is the prime pair.
[AGENT][NEUTRAL] No, this is secondary only.
[CUSTOMER][NEUTRAL] And that one is 6.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] $64.50.
[AGENT][NEUTRAL] And I do not show we received that claim.
[CUSTOMER][NEUTRAL] OK, uh, members effective date.
[AGENT][NEUTRAL] Uh, effective date was.
[AGENT][NEUTRAL] [PII], policy terms.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, and do you have any call reference number?
[AGENT][NEUTRAL] Uh, if you like, you may use my name in today's date.
[CUSTOMER][POSITIVE] OK. uh, thank you. That's all I need for today and have a very blessed day ahead.
[AGENT][NEUTRAL] Mhm, thank you for calling APL bye.
[CUSTOMER][NEUTRAL] Mhm bye.