AccountId: 011433970860
ContactId: 1ae880aa-e09a-416e-8003-31bb07f84013
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 151020 ms
Total Talk Time (AGENT): 45440 ms
Total Talk Time (CUSTOMER): 78840 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/11/1ae880aa-e09a-416e-8003-31bb07f84013_20250211T20:41_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Good afternoon [PII] my name is [PII] and I'm calling, um, I have a question. I'm calling from a provider's office. Let me give you the member's ID number so we can look up a claim to see if you've received it. It's 022.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 95939 ML 8.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And may I have the date of service for the claim?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] For $5,792.
[AGENT][NEUTRAL] OK hold on one moment.
[AGENT][NEUTRAL] OK, so we don't have a claim on file with that total bills. Um, what's your tax ID?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, yeah, this is a different um provider too. Um, so no, there's no claim on file for your date of service with your total bills.
[CUSTOMER][NEUTRAL] OK, now, um, um, another question, do you guys, because we're, we're a facility, we usually bill on UBO4s, um, but for some reason your APL in our system is built, um, we have it set up to send a CMS 1500 claim form. I'm not sure why because our claims go out on a UBO4, so maybe that's the reason why you guys have not received it, um, so I just wanna confirm for the institution you guys.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Being that you guys are secondary, it is a UBO4 correct? or do you know?
[AGENT][NEUTRAL] Mhm. It can be, it can be either or whatever your facility uses, both itemized bill or the universal bill.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, and the fax number for you guys to send this is this [PII]?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] You're very welcome. Was there anything else I can assist you with today?
[CUSTOMER][POSITIVE] That's it. Have a nice day.
[AGENT][NEUTRAL] You also, [PII]. Thanks for calling APL. Bye bye.
[CUSTOMER][NEUTRAL] Bye bye.