AccountId: 011433970860
ContactId: ffd63a6d-f65a-42d1-a99b-b980da6b167d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 361089 ms
Total Talk Time (AGENT): 175329 ms
Total Talk Time (CUSTOMER): 152751 ms
Interruptions: 0
Overall Sentiment: AGENT=1.2, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/24/ffd63a6d-f65a-42d1-a99b-b980da6b167d_20250224T13:48_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Good morning, [PII]. My name is [PII]. I'm calling from Fast Pace, and I'm calling to check status on a claim, please.
[AGENT][NEUTRAL] OK, [PII], you have one claim to check status on, is that correct?
[CUSTOMER][NEUTRAL] Yeah, just one claim.
[AGENT][POSITIVE] Yeah. Yes, ma'am. I can help you with that. And what is your callback number, please?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][POSITIVE] Thank you and the member's policy number please [PII].
[CUSTOMER][NEUTRAL] It is 683-335-170.
[AGENT][NEUTRAL] OK, so I just spoke to someone else on this. OK, so that is not an actual policy number for APO. Do you have another number?
[CUSTOMER][NEUTRAL] OK, so, um, if you spoke.
[AGENT][NEUTRAL] Is that the social? That's the social, correct?
[CUSTOMER][NEUTRAL] Um, let me look and see. So I
[CUSTOMER][NEUTRAL] Let me look and see in the paperwork because it's a different number than the patients so let me just see if that's what.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] And give me that number one more time. Maybe I missed one digit that you said. I'm so sorry.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] 68
[CUSTOMER][NEUTRAL] No, no, they didn't, they didn't present a card either, so I'm kind of like flying in the wind here, um, so.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] It's 683-335-170.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And it does not match the patient's social, if, if it is a social, it's a different one and it's not.
[CUSTOMER][NEGATIVE] The paperwork um that they sold out is incomplete.
[CUSTOMER][NEUTRAL] So I can't tell you if it's a social or not. I don't know.
[AGENT][POSITIVE] OK, so let's see, we'll just do the best that we can, alright, but [PII], I can certainly try and help you with this. And so tell me again, you're needing to, what, what, how can I help you today?
[CUSTOMER][NEUTRAL] We filed the claim electronically and we just haven't received a response and I'm calling to see if you have it and if it's been processed.
[AGENT][NEUTRAL] OK, so first off, any information that I do provide for you would be a verification of benefits and not a guarantee of payment. Excuse me, payment, what is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] Her name is [PII]. Her date of birth is [PII].
[AGENT][NEUTRAL] OK, and the data service and total bill amount for her place?
[CUSTOMER][NEUTRAL] 115 of 2024 and we billed out $342.02.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, so first off, the correct policy number that you should have for this number.
[AGENT][NEUTRAL] Is 02.
[AGENT][NEUTRAL] 59.
[AGENT][NEUTRAL] 053 9.
[AGENT][NEUTRAL] And this policy has an effective date of 11-5-2024.
[AGENT][NEUTRAL] OK, let me see if we did receive.
[CUSTOMER][NEUTRAL] OK, so she came in the day that the policy was inactive, OK.
[AGENT][NEUTRAL] Mhm, so give me just a moment to see if we have a claim on file for her.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And we do not. There is no claim on file for 115-2024, um.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] What is the mailing address or payer ID that you have for this number?
[CUSTOMER][NEUTRAL] Um, so let's see where they sent it.
[AGENT][NEUTRAL] Sure
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So the payer ID that they sent it to is 60801.
[AGENT][NEUTRAL] That is our payer ID there and you, let me make sure I heard you. 1105-2024, is that correct?
[CUSTOMER][NEUTRAL] Yes, but because I, we have the wrong ID number from the get go, I can't, it's probably what happened is you probably couldn't identify that ID number, so is there a group number?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm, just one moment.
[CUSTOMER][NEUTRAL] So I can fix this and send it back out, correct.
[AGENT][NEUTRAL] OK. The current group number is 25565.
[CUSTOMER][POSITIVE] OK, [PII], thank you so much. And do you give reference numbers?
[AGENT][NEUTRAL] Yes ma'am, you will actually use my name along with today's date and then also [PII], once we have received and processed the claim, we do have a portal in which you should be able to check claim status in by going to [PII].
[CUSTOMER][NEUTRAL] Oh yeah.
[CUSTOMER][NEUTRAL] What is it secured what?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]. Do I have to sign up for that or is it really easy?
[AGENT][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Yes, ma'am. It's a self registering portal and you would just so do the I'm a so like I am a dental or medical provider and then walk through the steps of answering the questions and creating your own username and password.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][POSITIVE] All right. I'll sign up for that. Thank you so much. You've been so helpful today.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Oh, well, you're very welcome. It was my pleasure. So is there anything else I can help you with at the moment, [PII]?
[CUSTOMER][POSITIVE] No, you have a great day.
[AGENT][POSITIVE] Well, I hope you do too, and thank you again for calling APL.
[CUSTOMER][NEUTRAL] Bye-bye.
[AGENT][NEUTRAL] Bye bye.