AccountId: 011433970860
ContactId: 144bbe40-f55c-487c-a412-cee5ecb3587a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 476829 ms
Total Talk Time (AGENT): 153869 ms
Total Talk Time (CUSTOMER): 144211 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/06/144bbe40-f55c-487c-a412-cee5ecb3587a_20250106T13:44_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII] calling from provider's office. How are you doing?
[AGENT][POSITIVE] I'm good [PII], how are you? And how can I help you today?
[CUSTOMER][NEUTRAL] I'm looking for a claim status.
[AGENT][NEUTRAL] OK, I can assist you. What's the policy number and a good phone number or callback number in case we're disconnected?
[CUSTOMER][NEUTRAL] The callback number is [PII] with the [PII] [PII].
[AGENT][NEUTRAL] Can you repeat the extension, please?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] OK, and the policy number?
[CUSTOMER][NEUTRAL] It's 01734133 M as in Mary, L as in Lima, and the number 8.
[AGENT][NEUTRAL] The patient's name and date of birth?
[CUSTOMER][NEUTRAL] The patient's name will be [PII], and the date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you for that information, [PII], and you said that you're checking claim status, could you provide the date of service and the charge amount?
[CUSTOMER][NEUTRAL] Sure. The date of service will be [PII].
[CUSTOMER][NEUTRAL] And the total bill amount will be $1,691 even.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][POSITIVE] Sure, take your time.
[AGENT][NEUTRAL] You said [PII]?
[CUSTOMER][POSITIVE] Uh yes, that's correct.
[AGENT][NEUTRAL] $1,691 even correct?
[CUSTOMER][POSITIVE] Yes, that's correct.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] Yeah, I show that this claim was received [PII].
[AGENT][NEUTRAL] Processed [PII].
[AGENT][NEUTRAL] And I show that the outpatient benefit for this calendar year has been met, so no payment was made.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] On this claim?
[AGENT][NEUTRAL] Let me know when you're ready for the claim number.
[CUSTOMER][NEUTRAL] Can you please help me with the claim number?
[AGENT][NEUTRAL] That number is 535227.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 88.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Thank you so much for that. Uh, so, as per our information, we have sent the claim again on [PII]. Could you please help me with the status after the [PII]?
[AGENT][NEUTRAL] Why was the claim resubmitted?
[CUSTOMER][NEUTRAL] Oh, I, I don't have that information, but, uh, as per our system it's showing that the claim was again submitted on.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, I do not show another claim for this state of service received.
[CUSTOMER][POSITIVE] OK, thank you so much for that. Give me a moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So as we did not receive any EOC of the claim which you have said with the claim number.
[CUSTOMER][NEUTRAL] 35 Q. 2788. Can you please access the EOB?
[AGENT][NEUTRAL] OK, so the explanation of benefits is mailed the next business day after the claim is processed. Can you verify your billing address? And then you can also download the ELB from our website, and I'll give you the website and I can help you create the account for the website as well.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Uh, we didn't.
[CUSTOMER][NEUTRAL] Uh, sure, so the billing address is going to be.
[CUSTOMER][NEUTRAL] Give me a moment. Uh, yeah, so it's [PII].
[AGENT][NEUTRAL] Is that the address that's on the claim that was sent to American Public Live?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK, so I'm looking at the claim that was submitted and the EOB was mailed to the address that's on your claim. I'm showing a [PII].
[CUSTOMER][NEUTRAL] Uh, as we did not receive the UB until now, can you please access the UB again?
[AGENT][NEUTRAL] We can fax it, but you can also create an account on our online service center. Let me know when you're ready for that address and we can help you get that set up, OK?
[CUSTOMER][NEUTRAL] Uh, sure.
[AGENT][NEUTRAL] Let me know when you're ready for the address.
[CUSTOMER][NEUTRAL] Go ahead.
[CUSTOMER][NEUTRAL] Uh, go ahead.
[AGENT][NEUTRAL] OK, I'll spell it out. It's [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And let me know when you get to the home page that says online service center welcome.
[CUSTOMER][NEUTRAL] Uh, give me, give me a moment, give me a moment.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] So, I'm showing that we do not have access for this link.
[AGENT][NEUTRAL] When you say you don't have access, what does that mean?
[CUSTOMER][NEUTRAL] So we are not authorized to open those websites in our system. I will get in contact. Yeah, sure. It's [PII].
[AGENT][NEUTRAL] OK. And what is your fax number?
[AGENT][POSITIVE] OK, any other questions I can help out with today?
[CUSTOMER][POSITIVE] Uh, there's nothing, thank you so much for asking.
[AGENT][POSITIVE] You're welcome and thank you for calling ATL Alina. Have a good day.
[CUSTOMER][NEUTRAL] Uh, before that, can you please help me with the call reference?
[AGENT][NEUTRAL] My name and today's date, [PII], first [PII] last name is [PII].
[CUSTOMER][POSITIVE] Thank you so much for your information. Have a great day.
[AGENT][POSITIVE] You're welcome thank you for calling APL have a good day.
[CUSTOMER][NEUTRAL] Bye bye.