AccountId: 011433970860
ContactId: 1c3bf6e4-4fb7-4e38-8a8c-ee1f5c7ae513
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 270410 ms
Total Talk Time (AGENT): 99375 ms
Total Talk Time (CUSTOMER): 122826 ms
Interruptions: 0
Overall Sentiment: AGENT=1.5, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/24/1c3bf6e4-4fb7-4e38-8a8c-ee1f5c7ae513_20250324T18:58_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], I'm [PII] calling from provider service. I just want to check the status.
[AGENT][POSITIVE] OK, well I can definitely help you with the claim status and for my notes, can you spell your first name for me please and provide a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Oh yeah. Uh, first name is [PII], last name initial [PII].
[CUSTOMER][NEUTRAL] And callback number [PII].
[AGENT][NEUTRAL] Thank you. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] first number is 02554747.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] First name is [PII] and last name is [PII].
[CUSTOMER][NEUTRAL] Date of birth, [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And [PII], may I have a um the date of service for the claim?
[CUSTOMER][NEUTRAL] Data services uh [PII].
[CUSTOMER][NEUTRAL] Total bill amount is $764.59.
[AGENT][NEUTRAL] $775.59.
[CUSTOMER][NEUTRAL] Uh, 764, sorry, 64 pounds.
[AGENT][NEUTRAL] 764.59.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, um, so I'm actually showing that we have not processed any claims for Tanya yet. Um, so there's no claim on file, but there's no timely filing, um, so you can still file it if you'd like.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Uh yes. Uh, the patient is, uh, primary is Cigna. Then Cigna was pro uh.
[CUSTOMER][NEUTRAL] Paid and then other balances.
[CUSTOMER][NEUTRAL] Goes to
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] Secondary, could you please verify if there are any claims under
[CUSTOMER][NEUTRAL] This
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] So our secondary policy is second only to Well Net Healthcare. Um, that's, that's the primary insurance our policy goes to, but we haven't, like it's literally blank. We have never processed a claim for her. We haven't processed the claim for her yet.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] There
[CUSTOMER][NEUTRAL] OK. We will, uh, we can send the primary EOS.
[CUSTOMER][NEUTRAL] Via fax or mail. What's the preferred one?
[AGENT][NEUTRAL] Well, we'll need the full claim.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] For the date of service is [PII].
[CUSTOMER][NEUTRAL] Total amount $764.59.
[AGENT][NEUTRAL] Yes, so you still have time to submit. We don't have a timely filing, so you can resubmit the claim. We haven't received the claim at all. So you can resubmit it to us for processing.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] OK, and.
[CUSTOMER][NEUTRAL] Uh, do you have any fax number then I can submit with the primary EOP.
[AGENT][NEUTRAL] Sure. Our fax number is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Just for the confirmation, [PII], yes?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] OK. And can I have your name and call reference number?
[AGENT][NEUTRAL] Sure, my name is [PII] The first initial to my last name is [PII], and there's no call reference number, but you can use my name and today's date.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, sure.
[CUSTOMER][POSITIVE] And thank you very much, [PII]. Have a nice day. Bye.
[AGENT][NEUTRAL] You're welcome, [PII]. Was there anything else I can assist you with today?
[CUSTOMER][NEUTRAL] Uh, no, that's all.
[AGENT][POSITIVE] Alright, well thanks for calling APL and I hope you have a great day.
[CUSTOMER][NEUTRAL] Yeah, you too. Bye.
[AGENT][POSITIVE] Thank you, bye bye.