AccountId: 011433970860
ContactId: 13067e7b-6db9-4157-ab12-f93a2bca120c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 360540 ms
Total Talk Time (AGENT): 153033 ms
Total Talk Time (CUSTOMER): 120008 ms
Interruptions: 0
Overall Sentiment: AGENT=1.8, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/01/13067e7b-6db9-4157-ab12-f93a2bca120c_20250501T17:21_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APO. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, yes, my name is [PII] and I'm calling from Central Emergency Medical Services, and I wanted to follow up on a claim for a patient.
[AGENT][NEUTRAL] OK [PII], you're needing to check claim status, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Yes ma'am, I can help you with that and what is a good call back number for you please?
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][POSITIVE] Thank you and the member's policy number please.
[CUSTOMER][NEUTRAL] I have 022-03757.
[AGENT][POSITIVE] OK, thank you. Give me a couple of moments [PII] to get the member's information pulled up please.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] And [PII], any information that I do provide for you today would be a verification of benefits and not a guarantee of payment. What is your patient's name please and date of birth?
[CUSTOMER][NEUTRAL] It is [PII] and it's [PII].
[AGENT][NEUTRAL] OK, I'm sorry, what is the last name?
[CUSTOMER][NEUTRAL] Uh, I'll spell it. It's [PII]
[AGENT][NEUTRAL] OK, thank you. And the date of service and total bill amount please.
[CUSTOMER][NEUTRAL] The date of service is [PII]. The bill amount was $1210.67.
[AGENT][NEUTRAL] OK, thank you, and again I'm just gonna repeat that data service you did say [PII].
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And bill amount was $1210.67.
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK, thank you. One moment.
[AGENT][NEUTRAL] OK, so I do not show a claim received for that data service and that total bill amount for this member.
[CUSTOMER][NEUTRAL] OK, that's interesting. Um, we faxed it multiple times and
[CUSTOMER][NEUTRAL] I'm trying to look here.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Yeah, because we talked to somebody back in March and.
[CUSTOMER][NEUTRAL] The rep gave us a fax number and told us to send it to that fax number and it looks like we sent it um.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] One
[CUSTOMER][NEUTRAL] To
[CUSTOMER][NEUTRAL] 3 times.
[AGENT][NEUTRAL] To what number did you
[CUSTOMER][NEUTRAL] On 3 different dates.
[AGENT][NEUTRAL] Yes ma'am, uh, we've not received a claim for this state of service. What fax number were you sending it to?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Attention claims.
[CUSTOMER][NEUTRAL] Um, yeah, let me look here and see, yes, claims.
[AGENT][NEUTRAL] So I'm not sure if that's what, if that's an issue on, you know, which side, but we, we do not have a claim on file for that bill amount and that dated, and that's the total bill amount on the claim.
[AGENT][NEGATIVE] $1210.60. Yes, ma'am, we've not received that.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Now, if you would rather, since you've, you can try and fax it again or I can also give you the claim's mailing address.
[CUSTOMER][NEUTRAL] OK. Is there
[CUSTOMER][NEUTRAL] OK, yeah, what is the mailing address? Uh, is it the, um, [PII]?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm. [PII].
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yeah, because I saw that just now it looks like we've mailed it once.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] OK, so something
[CUSTOMER][NEUTRAL] But I can mail it and fax it again. Mhm.
[AGENT][NEUTRAL] Yeah, cause yes, we're, we're not receiving that. So again, I don't know where the breakdown is. And just make sure that too when you submit it, [PII], that a copy of the primary insurance company's explanation of benefits is also included cause we do have to have that.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And then once the claim has been received and processed by APL we do have a portal that you should be able to check our claim status in and the website for that is secured.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] All right, perfect. Thank you so much.
[AGENT][POSITIVE] Well, you're certainly very welcome. So is there anything else that I could help you with?
[CUSTOMER][NEUTRAL] Um, no, that is it. Do you happen to have a reference number?
[AGENT][NEUTRAL] Yes, ma'am, you would just use my name that I gave you along with today's date.
[CUSTOMER][POSITIVE] OK, perfect. Thank you so much.
[AGENT][POSITIVE] OK, well, you're certainly very welcome so if that is all I can help you with, thank you again for calling APL and I hope you have a wonderful afternoon.
[CUSTOMER][POSITIVE] You as well. Thank you. Bye-bye.
[AGENT][POSITIVE] Uh-huh, thank you too. Bye-bye. Bye.