AccountId: 011433970860
ContactId: 23ea3301-96b1-483b-9dc9-356b7b4e683b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 400290 ms
Total Talk Time (AGENT): 133818 ms
Total Talk Time (CUSTOMER): 113875 ms
Interruptions: 1
Overall Sentiment: AGENT=0.4, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/28/23ea3301-96b1-483b-9dc9-356b7b4e683b_20250228T18:09_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII] and I'm calling from Pinellas County EMS Sunstar Ambulance, and I'm trying to get a status on a claim. We had a claim that denied for the primary EOB, which was faxed over back in July, and we still haven't received anything.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] Hm. All right, let's take a look, so. What is the policy number?
[CUSTOMER][NEUTRAL] It is 02203927 ML 8.
[CUSTOMER][NEUTRAL] For [PII].
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And then if you could just verify her date of birth.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And then what's the date of service?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] $946.37
[AGENT][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] It looks like you guys are 2nd to Cigna.
[AGENT][NEUTRAL] Yeah, wait, it looks like she has a secondary with us. Let me see here.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEGATIVE] Yeah, I still show it as a denial. Do you have the fax number you guys sent it to [PII]?
[CUSTOMER][NEUTRAL] Uh yes, let's see here [PII].
[AGENT][NEUTRAL] Uh, that should be right, [PII].
[CUSTOMER][NEUTRAL] Yeah, we got a confirmation.
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] Cause yeah, it's not showing.
[AGENT][NEUTRAL] I don't see anything on our side.
[CUSTOMER][NEUTRAL] Is there an email I can send it?
[AGENT][NEUTRAL] No, we don't have an email unfortunately they can be sent to wonder.
[CUSTOMER][NEGATIVE] Yeah, well, we tried the fax that's not working.
[AGENT][NEUTRAL] Let me see if I see anything under any of the other members may be an error or something.
[AGENT][NEUTRAL] Yeah, I checked under the other members too. I don't see anything there that you know it got maybe misplaced under the wrong member or anything like that, um, at this.
[CUSTOMER][NEUTRAL] Yeah, no, you guys did receive it. I, I don't know what you did with it, but we did send it.
[AGENT][NEUTRAL] Yeah, um, all I can say at this point too is you guys can resubmit it via fax or send it in the mail. That's the only other way to send it.
[CUSTOMER][NEUTRAL] OK, just fold it up and put it in the mail.
[AGENT][NEUTRAL] Do you guys have the claim number and the EOB? Did you get any of that?
[CUSTOMER][NEGATIVE] No, we haven't received anything. We got the, we got the original denial saying that you guys are requesting the EOB, which was back in [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And we sent it out like the same day it was faxed out.
[CUSTOMER][NEUTRAL] Because we called and I have a reference number [PII] B72324 spoke to her on [PII] gave us the fax number and everything we sent it out, got the uh fax confirmation back OK.
[CUSTOMER][NEUTRAL] So I don't know where it went.
[AGENT][NEUTRAL] Yeah, no, I see that you spoke with [PII] back on [PII] or [PII]. I see your notes in here.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] The fax number for the claims department.
[AGENT][NEUTRAL] Um, I can submit. Do you guys have a fax? I can submit the EOB to you and you can submit that with the primary EOB because it would have the claim number and everything and the denial on it.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] What's the fax number?
[CUSTOMER][NEUTRAL] Are you able to email that?
[AGENT][NEUTRAL] Um, I can't email it. I can only fax.
[CUSTOMER][NEUTRAL] OK, if you just put attention [PII] when you fax it, yeah.
[AGENT][POSITIVE] I will, yeah, absolutely.
[AGENT][NEUTRAL] Do you have a last initial you want me to add on there or just [PII]?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] What's the fax number?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Let's see here, it's [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. Um, that is sent, so should be there in about 5 minutes. I marked it attention to Sue P, P as in Peter.
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][POSITIVE] Thank you so much.
[AGENT][POSITIVE] All right. Yeah, you're welcome, [PII]. I'm sorry for the frustration.
[CUSTOMER][NEUTRAL] Oh, that's OK. Better luck this time.
[AGENT][POSITIVE] All right. Have a good day.
[CUSTOMER][NEUTRAL] You too, bye bye.
[AGENT][NEUTRAL] Bye.