AccountId: 011433970860
ContactId: 0db43fc5-6913-4f14-8d7b-0685ae2e5ab2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 369760 ms
Total Talk Time (AGENT): 146217 ms
Total Talk Time (CUSTOMER): 130529 ms
Interruptions: 1
Overall Sentiment: AGENT=0.8, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/15/0db43fc5-6913-4f14-8d7b-0685ae2e5ab2_20250515T19:58_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thanks for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm calling from the provider's office for claims. Could you help me with that, ma'am?
[AGENT][NEUTRAL] Sure, I can verify claim status for you and your name is again?
[CUSTOMER][NEUTRAL] It's [PII]
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] OK, and [PII], what is that policy number, please?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Uh yes. The policy number is gonna be uh 2 sorry, 02460660.
[AGENT][NEUTRAL] OK, thank you, one moment.
[AGENT][NEUTRAL] And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] Uh yes, it's [PII] and it's a direct line.
[AGENT][NEUTRAL] OK, thank you and verify the patient's name, date of birth.
[CUSTOMER][NEUTRAL] Yes. First name is [PII], last name is [PII], and date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you. And what was the date of service and amount of the charge?
[CUSTOMER][NEUTRAL] Uh, yes. The data service starts with [PII].
[AGENT][NEUTRAL] OK, and the amount of the charge?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, so this is $9,158.68.
[AGENT][NEUTRAL] OK, thank you. And do you have the balance after Primary has processed the claim?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Uh yes. Uh, there are balance is $3470.81.
[AGENT][POSITIVE] OK, thank you. Give me one moment please.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Um, I don't show we received a claim for that data service. Can you verify the mailing address it was submitted to?
[CUSTOMER][NEUTRAL] Uh yes, sure. Uh, the mailing address is [PII].
[AGENT][NEUTRAL] Uh, no, sir. Our mailing address changed [PII], so when you're ready I can give you the correct mailing address.
[CUSTOMER][NEUTRAL] Sure, ma'am. I'm ready for the address.
[AGENT][NEUTRAL] OK, it's [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Uh, could you please check, uh, patient is active on the data service.
[AGENT][NEUTRAL] Yes, affected, well, no. Uh, give me one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Uh, don't show that they were active on that data service on this plant. Give me one moment.
[CUSTOMER][POSITIVE] Sure, ma'am. Take your time.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Yes
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] That
[AGENT][NEUTRAL] Sorry, give me one moment.
[CUSTOMER][POSITIVE] Mhm. Take your time, ma'am.
[AGENT][NEUTRAL] So they had another policy prior to this one that they were effective in. I was just checking to see if we received it under this policy. Give me one moment. You said [PII], correct?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] And this was for the facility? Yeah.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. Uh, I do show that claim was received and it looks like uh it processes needing the primary insurance explanation of benefits.
[CUSTOMER][NEUTRAL] OK you need the uh primary insurance here, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK. Uh, could you have, uh, could you please send the Urofax if it's possible?
[AGENT][NEUTRAL] Uh, the EOB requesting the primary EOB?
[CUSTOMER][NEUTRAL] So, uh
[CUSTOMER][NEUTRAL] No, the second you'll be.
[AGENT][NEUTRAL] So you're wanting, OK, what's the fax number?
[CUSTOMER][NEUTRAL] So [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] And uh before that, could you help me with the claim number and the received date?
[AGENT][NEUTRAL] Sure, give me a moment. Uh, the claim number is 3373682.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And the claim was, give me a moment.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] A claim was received on [PII], processed on [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Could you help me with the uh name and the reference number?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] It's [PII], K E K E, last initial Q as in Quebec, and [PII], is there anything else I can assist you with today?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] No, ma'am, I do have only one claim for today.
[AGENT][POSITIVE] OK, uh, thanks for calling APL. Have a great day.
[CUSTOMER][NEUTRAL] What do you want the reference number?
[AGENT][NEUTRAL] As I said, you may use my name at today's date. My name is spelled [PII] last initial [PII]
[CUSTOMER][NEUTRAL] Oh, OK. OK. OK, OK. Uh, yes, yes, uh.
[CUSTOMER][POSITIVE] Yeah, I got it. Thank you so much, ma'am. Thank you so much, ma'am, for assisting. Have a great day.
[AGENT][POSITIVE] You're welcome. Thanks for calling APL bye.
[CUSTOMER][POSITIVE] Thank you bye.