AccountId: 011433970860
ContactId: 13c26d2a-51f8-4d98-abc9-8f76b743283a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 296970 ms
Total Talk Time (AGENT): 127984 ms
Total Talk Time (CUSTOMER): 108546 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/07/13c26d2a-51f8-4d98-abc9-8f76b743283a_20250307T21:01_UTC.wav
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[AGENT][NEUTRAL] Afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Uh yes, my name is [PII]. I'm looking for a claim status.
[AGENT][POSITIVE] It would be a pleasure to assist you with that claim status, [PII]. What is a good callback number?
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Thank you, [PII] and the policy number for the patient, please?
[CUSTOMER][NEUTRAL] Yeah, it's 01997050.
[AGENT][NEUTRAL] And what is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yeah, the patient's first name is [PII] and the last name is [PII] Date of birth is [PII].
[AGENT][POSITIVE] All right, thank you, and [PII], it would be my pleasure to assist you with that claim status. Do you have the claim number or date of service?
[CUSTOMER][NEUTRAL] Oh yeah, I have a date of service. It's been on [PII] build amount 1050.
[CUSTOMER][NEUTRAL] I.
[AGENT][NEUTRAL] Thank you, [PII]. And what is the
[AGENT][NEUTRAL] Facility name.
[CUSTOMER][NEUTRAL] Yeah, it's anesthesio affiliates LLC.
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] So we did receive that claim. Let me get that received date for you. Bear with me one moment.
[CUSTOMER][POSITIVE] Yeah, sure take your time.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] And we did receive that claim on [PII].
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] [PII], sorry, could you repeat it?
[AGENT][NEUTRAL] It was
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It was processed on [PII].
[AGENT][NEUTRAL] And the claim is pending for the primary EOB.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I gave this to me.
[CUSTOMER][NEUTRAL] And uh what was the claim number?
[AGENT][NEUTRAL] Claim number is 344.
[AGENT][NEUTRAL] 9310.
[CUSTOMER][NEUTRAL] OK. And uh uh OK. What about the status of claim? It's uh 182.55. What about that amount?
[AGENT][NEUTRAL] 182.55 same data service.
[CUSTOMER][NEUTRAL] Hello
[CUSTOMER][NEUTRAL] No, no, no. I'm asking about the remaining balance is 182.55. What about that amount?
[AGENT][NEUTRAL] Well, we weren't able to complete the processing of the claim. It's pending for the primary EOB. We are secondary to the policyholder's major medical insurance.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so it is done for the primary UB, right?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] Yeah, OK. And uh who's the primary uh insurance?
[AGENT][NEUTRAL] I can get that for you. One moment.
[CUSTOMER][NEUTRAL] Yeah, sure.
[AGENT][NEUTRAL] [PII], we have all state benefits on file as primary.
[CUSTOMER][NEUTRAL] OK, but in my system, it's showing Eli Be First Health. It was a primary insurance.
[AGENT][NEUTRAL] And we're needing the EOB from the primary. We have in the system all state benefits listed as their primary. You might wanna contact the patient to verify that.
[CUSTOMER][NEUTRAL] OK. You have the uh Allstate, uh, insurance, uh, sorry, ID name?
[AGENT][NEUTRAL] We do not. You would need to contact the insured.
[CUSTOMER][NEUTRAL] And you don't have any details about the COB uh related like last CO be updated.
[AGENT][NEUTRAL] No, not
[AGENT][NEUTRAL] Well, that was, um, for the effective date of the policy which was.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] To [PII], it was effective date and you don't have the details of the last PUP update details?
[AGENT][NEUTRAL] No sir, no ma'am, we're secondary, so that's not we don't coordinate I mean we do.
[AGENT][NEUTRAL] We are secondary to the primary.
[AGENT][NEUTRAL] Not major, we're not major medical.
[CUSTOMER][NEUTRAL] OK. Uh, the second.
[CUSTOMER][NEUTRAL] OK, fine. And what was your, uh, what was the claim number?
[AGENT][NEUTRAL] Claim number is 3,449,310.
[CUSTOMER][NEUTRAL] OK. What was the call reference number?
[AGENT][NEUTRAL] Call reference number is my name and today's date, and I spell my name [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, fine. Thank you. Thank you so much.
[AGENT][POSITIVE] And thank you, [PII] for calling APL. Hope you have a wonderful day. Happy weekend.
[CUSTOMER][POSITIVE] Yeah, happy weekend.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Bye bye.