AccountId: 011433970860
ContactId: 0053ad01-8f17-4cc0-8b64-0d8b943933ca
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1119489 ms
Total Talk Time (AGENT): 248645 ms
Total Talk Time (CUSTOMER): 322077 ms
Interruptions: 1
Overall Sentiment: AGENT=0.8, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/11/0053ad01-8f17-4cc0-8b64-0d8b943933ca_20250411T14:43_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, I'm [PII] calling from our provider office to check on a claim status. And please be informed that this call will be recorded and monitored for quality and training purposes. Sorry, I didn't get your name. Could you please spell your name for our documentation purpose?
[AGENT][NEUTRAL] My name is [PII]. That's [PII].
[CUSTOMER][POSITIVE] OK. Thank you for that.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] You're welcome. And may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] OK, sure. It's [PII] and the extension to my callback number is [PII].
[AGENT][NEUTRAL] OK, thank you. And you're calling from which facility from my location?
[CUSTOMER][NEUTRAL] Yeah, sure. It's Fort Lar Physician Services LLC.
[AGENT][NEUTRAL] OK. No, thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Yeah, sure. It's 246-034-8.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Let me just a second
[AGENT][NEUTRAL] OK, may I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Yes, it's [PII], and the date of birth, [PII].
[AGENT][NEUTRAL] No, OK. And what is the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] Yeah, sure. It's [PII].
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] [PII]. How much is the total charge?
[CUSTOMER][NEUTRAL] It's $1470 even.
[AGENT][NEUTRAL] OK, thank you. One moment, let me see if I can find that claim for you.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And for future you can check claim status online through our website at [PII] and that's just optional and let's see. OK, it looks like we're needing the explanation of benefits from the primary insurance to continue the processing of this claim.
[CUSTOMER][NEUTRAL] Yeah, so check that.
[CUSTOMER][NEUTRAL] No, uh, we are able to live. I think you are a primary.
[AGENT][NEUTRAL] No, we're not. Um, let me tell you who's the primary, bear with me.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] And the primary is United Healthcare.
[CUSTOMER][NEUTRAL] Uh, for the date of service, uh, uh, you're not a premier or current?
[AGENT][NEUTRAL] We're always the secondary.
[AGENT][NEUTRAL] United Healthcare is the primary. Mhm.
[CUSTOMER][NEUTRAL] OK, just
[CUSTOMER][NEUTRAL] Thank you for that. OK. Could you please help me with the United Healthcare policy ID?
[AGENT][NEUTRAL] We don't have that information. We can only see the name of the major medical. We don't have the phone number. We don't have the policy number so you have to get in contact with you know um with United Healthcare to get that information or with the number.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] OK. Thank you for that. Uh, just a moment, please.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Thank you for your patience. Uh, just a moment. Uh, I'm just finding an, OK, I'm just finding an AHC.
[AGENT][NEUTRAL] Mhm, sure.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, just some.
[CUSTOMER][NEUTRAL] OK. Thank you for your patience. Uh, could you please help me with the call reference number for this claim?
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in today state if you will.
[CUSTOMER][NEUTRAL] OK. Do you have any claim number for this claim?
[AGENT][NEUTRAL] Um, yes, the claim number, yes, we do have the claim number. Bear with me just a second. Let me pull that up again.
[CUSTOMER][NEUTRAL] OK. OK.
[AGENT][NEUTRAL] OK um let's see.
[AGENT][NEUTRAL] That is claim number 3479652.
[CUSTOMER][NEUTRAL] But thank you for that. Could you please help me with the received date and the date of the claim?
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] OK, it was received [PII], processed [PII].
[CUSTOMER][NEUTRAL] Cross was on [PII]. Am I right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] OK, thank you for that. Uh.
[CUSTOMER][POSITIVE] No problem.
[CUSTOMER][NEUTRAL] Let, uh, for this time we, we need to submit to EC and then we can submit to you, am I right? I think you're a secondary.
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] Yes, uh-huh.
[CUSTOMER][NEUTRAL] Yes. OK. I do, I do, OK, I do have another client for the same patient. Could you please help me with that?
[AGENT][NEUTRAL] And what is the date of service?
[CUSTOMER][NEUTRAL] OK, just a moment. I'm just pulling out the claim.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Uh, for this, the date of service is [PII].
[AGENT][NEUTRAL] Yeah, what's the amount of the claim?
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] What's the amount?
[CUSTOMER][NEUTRAL] Oh, sorry. I didn't get that. Just a moment. It's $683 even.
[AGENT][NEUTRAL] OK, we also need the primary EOB for this one.
[AGENT][NEUTRAL] So this one
[CUSTOMER][NEUTRAL] OK. Uh, this also we need to submit to VHC.
[AGENT][NEUTRAL] Yes, mhm, and it's the same received date and process date as the previous one.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Uh, OK, could you please tell me the client number for this client?
[AGENT][NEUTRAL] Mhm. It's 347-96555.
[CUSTOMER][NEUTRAL] OK, thank you for that. Uh, I do have another client for the same patient. Could you please help me with that?
[AGENT][NEUTRAL] OK, what is the date of service?
[CUSTOMER][NEUTRAL] OK, just a moment. Uh, it's [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Thank you. What is the amount?
[CUSTOMER][NEUTRAL] It's $1,652 even.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK, I see that amount. Let me check this one.
[CUSTOMER][POSITIVE] Yeah, sure, take your time.
[AGENT][NEUTRAL] Can you
[AGENT][NEUTRAL] Yeah, can you double check that amount just to make sure because I see here there's one here, but it's not that amount.
[CUSTOMER][NEUTRAL] Uh, it's $1,652 even.
[AGENT][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, yeah, we also need the EOB, the primary EOB for this one.
[CUSTOMER][NEUTRAL] OK. Uh, for this also, we need to submit to UFC and then we need to submit to you. Am I right?
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] It's the same received date or processed date.
[AGENT][NEUTRAL] Yeah, it's the same receipt date and process date [PII] and the claim number on this one is 3479654.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] OK, thank you for that. Uh, uh, I do have one another claim. It's a last claim, uh, for a different patient. Could you please help me with that?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Um, yes, let me just make a note on this one and then we can move forward to the next one, OK? One moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Yeah, sure, take your time.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] Gonna be one more minute.
[CUSTOMER][POSITIVE] No, take your time, no problem.
[AGENT][NEUTRAL] OK, what's the next policy number?
[CUSTOMER][NEUTRAL] Yeah, sure. It's for, uh, it's for a different uh member and for a different uh building area.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK. What's the policy number?
[CUSTOMER][NEUTRAL] Right
[CUSTOMER][NEUTRAL] Uh, it's 01062704.
[AGENT][NEUTRAL] Can you repeat that one more time?
[CUSTOMER][NEUTRAL] Oh, sure. It's 010.
[CUSTOMER][NEUTRAL] 627-04.
[AGENT][NEUTRAL] What's the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Yeah, sure. It's [PII].
[CUSTOMER][NEUTRAL] Var
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] What's your date of birth?
[CUSTOMER][NEUTRAL] It's date of birth, uh, [PII].
[AGENT][NEUTRAL] OK, thank you. What is the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] Yes, sir. Uh, date of service [PII] and the total charge amount $1,428 even.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, um, we received the claim [PII], processed [PII], needed primary EOB for this one as well.
[AGENT][NEUTRAL] And
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me check and see if.
[CUSTOMER][NEUTRAL] Uh, the claim was received on.
[CUSTOMER][NEUTRAL] OK. The claim was received on uh
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK. And it was processed on [PII]. Am I right?
[AGENT][NEUTRAL] Mhm, yes.
[CUSTOMER][NEUTRAL] Uh it's [PII]. Could you please tell me the client number for this client?
[AGENT][NEUTRAL] OK, sure. That is 348-6158.
[CUSTOMER][NEUTRAL] A little
[CUSTOMER][NEUTRAL] OK. Thanks for that. Uh, could you please help me with, uh,
[CUSTOMER][NEUTRAL] May I know it's a primary?
[AGENT][POSITIVE] Yeah, I can check on that for you.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][POSITIVE] Yeah, sure, take your time.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] United Healthcare.
[CUSTOMER][POSITIVE] Oh, for this also, she noted OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, OK. And you're a secondary and united healthcare is a primary. Am I right? for the date of service?
[AGENT][NEUTRAL] Mhm
[AGENT][POSITIVE] Mhm. Correct.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, just a moment, just a moment, uh, I'll be right back.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, thank you for your patience. Uh, for this also call your call reference is your name and today's date. Am I right?
[AGENT][POSITIVE] Mhm. Correct.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][POSITIVE] Uh, yes. OK. Thank you for your assistance. So, have a great day.
[AGENT][NEUTRAL] as well. Is there anything else I can help you with today?
[CUSTOMER][NEUTRAL] Uh, no, it's nothing.
[AGENT][POSITIVE] OK. Thank you for calling APL and good afternoon.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Bye-bye.
[AGENT][NEUTRAL] Bye.