AccountId: 011433970860
ContactId: 056e1de4-cae3-4643-a776-660e08a60aa6
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 290940 ms
Total Talk Time (AGENT): 107336 ms
Total Talk Time (CUSTOMER): 122627 ms
Interruptions: 3
Overall Sentiment: AGENT=1.1, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/16/056e1de4-cae3-4643-a776-660e08a60aa6_20250516T21:45_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII]. I'm calling for claim status. Did you say your name was [PII]?
[AGENT][POSITIVE] Uh, yeah, [PII], and I can definitely check on a claim for you, [PII]. Uh, can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure, it is [PII] direct line.
[AGENT][NEUTRAL] Alright thank you and then do you have the policy number?
[CUSTOMER][NEUTRAL] It is 01988945 M as in Mary L as in Lima 7.
[AGENT][NEUTRAL] OK, and what was the name and date of birth for the member please?
[CUSTOMER][NEUTRAL] I have [PII] [PII].
[AGENT][POSITIVE] Perfect, thank you for verifying that and what was the date of service for this claim?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Data service is [PII] single date of service.
[AGENT][NEUTRAL] [PII] and then do you have that uh billed amount?
[CUSTOMER][NEUTRAL] Yes, $195,828.30.
[AGENT][NEUTRAL] OK. Now, was that the amount uh before or after major medical paid?
[CUSTOMER][NEUTRAL] That is the amount before.
[AGENT][NEUTRAL] OK, alrighty. One moment please.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so we did receive this claim, [PII]. It looks like we are missing the uh copy of the primary EOB.
[CUSTOMER][NEUTRAL] Primary EOB, OK, cause I know they were requesting medical records. We did submit that. Did you guys receive that?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Um, medical records. Let me see. They were requesting primary EUB.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, the only thing that it's stating that we're needing it looks like we have, mhm, it looks like we have everything else uh all it's stating that we're needing is that primary EOB.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, let me see. Who is that coming from [PII]. Let me see if we have that. Hold on.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] Give me 1 2nd, this page is just taking its time to load.
[AGENT][NEUTRAL] Sure, yeah, you're fine.
[AGENT][POSITIVE] Is ready for the weekend. I think all the everybody is, even the computers.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh yeah.
[CUSTOMER][NEUTRAL] OK, so I do have that will be, uh, I can't even speak now. Where can we fax that over to?
[AGENT][NEUTRAL] Sure, let me know when you're ready for that fax number.
[CUSTOMER][POSITIVE] I am ready.
[AGENT][NEUTRAL] OK, that is 877.
[AGENT][NEUTRAL] 365.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] 942 3.
[CUSTOMER][NEUTRAL] 365
[CUSTOMER][NEUTRAL] 9483. OK, is that attention to anyone?
[AGENT][NEUTRAL] Uh, 9, it's, I'm sorry, um, it's 9423.
[CUSTOMER][POSITIVE] 942-3. Thank you so much. So [PII]?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Correct, yes, and it would just be attention claims department.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Perfect. So I'll go ahead and fax over that primary EOB attention claims department. Should I reference the claim number which is what I have? Oh, I don't even have the claim. What is the claim number you guys have on file for this one?
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][POSITIVE] I do, I can give that to you. Yeah, I can give that to you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] That is 35.
[CUSTOMER][POSITIVE] Go ahead, I'm ready.
[AGENT][NEUTRAL] 75589.
[CUSTOMER][NEUTRAL] Alright, and when did you guys receive this claim?
[AGENT][NEUTRAL] Let me see.
[AGENT][NEUTRAL] This claim was received uh [PII], and it was processed [PII].
[CUSTOMER][NEUTRAL] Alright, and then I will take a reference number for the call and I'll get that EOB over to you guys.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Sounds good. Uh, so reference number would just be my first name, last initial, and today's date. Uh, so my last initial is A. Oh, is there anything else I could help you with, [PII]?
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][POSITIVE] No, that'll be all for today, [PII]. Thank you so much.
[AGENT][POSITIVE] Alright, of course, thanks for calling APL have a great weekend.
[CUSTOMER][POSITIVE] You too. Thank you.
[AGENT][POSITIVE] Thank you. Bye bye.
[CUSTOMER][NEUTRAL] Bye bye.