AccountId: 011433970860
ContactId: 06616ca4-8bcb-4b11-a3c2-e74b8c0a89eb
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 218699 ms
Total Talk Time (AGENT): 72134 ms
Total Talk Time (CUSTOMER): 69501 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/08/06616ca4-8bcb-4b11-a3c2-e74b8c0a89eb_20250508T19:55_UTC.wav
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[AGENT][NEUTRAL] For calling APL, my name is [PII]. How can I assist you today?
[CUSTOMER][NEUTRAL] Hi, [PII]. This is [PII]. I'm calling from provider's office. Checking your claim status.
[AGENT][POSITIVE] I'll be happy to assist with claim status today, [PII], if I can get a good call back number for you.
[CUSTOMER][NEUTRAL] The callback phone number is [PII].
[CUSTOMER][NEUTRAL] [PII] it's a direct line.
[AGENT][NEUTRAL] And what is the policy number?
[CUSTOMER][NEUTRAL] Policy number is 021.
[CUSTOMER][NEUTRAL] 99641
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] First name is [PII], last name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] And the date of service for the claim?
[CUSTOMER][NEUTRAL] The date of service, [PII].
[CUSTOMER][NEUTRAL] Billed amount $340 even.
[AGENT][NEUTRAL] Thank you for that information. I'm showing the claim was denied because the it wasn't covered by the primary, the primary denied.
[CUSTOMER][NEUTRAL] The yeah, the primary.
[CUSTOMER][NEUTRAL] Processed and applied towards the member's deductible.
[AGENT][NEUTRAL] OK, let me take a look at the EOB we received one moment please.
[CUSTOMER][NEUTRAL] Yeah. OK.
[AGENT][NEUTRAL] Actually, I can't see the documents.
[AGENT][NEUTRAL] Um, what's the procedure called for that claim?
[CUSTOMER][NEUTRAL] S as in Sam, 9083.
[AGENT][NEUTRAL] Yeah, that's what we have.
[AGENT][NEUTRAL] But I can't see the documents.
[AGENT][NEUTRAL] Is there any way that you can resubmit that claim?
[CUSTOMER][NEUTRAL] So, you have not received the primary EOB, the Aetna UOB?
[AGENT][NEUTRAL] I can't. I'm trying to pull it up and it's showing that there are no documents on here so I can't verify if it was processed correctly so if you can please uh resubmit.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] The claim?
[CUSTOMER][NEUTRAL] So, can we resubmit the only the primary EOB?
[AGENT][NEUTRAL] Yeah, that, that'll be fine.
[CUSTOMER][NEUTRAL] Yeah, so can I get the fax number where we can send the primary EOP?
[AGENT][NEUTRAL] 877.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And whose attention it should go to?
[AGENT][NEUTRAL] Claims department.
[CUSTOMER][NEUTRAL] And is there any time frame to submit that?
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] No? OK, and
[CUSTOMER][NEUTRAL] Can I get the call reference number?
[AGENT][NEUTRAL] Reference is just my name [PII] last initial [PII], and the date and time of the call. Was there anything else I could assist with today?
[CUSTOMER][NEUTRAL] Can you spell your name?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Last name initial?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Uh, OK, [PII], thanks for the information and you have a great day. Thank you. Bye-bye.
[AGENT][POSITIVE] Thank you for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] Yeah