AccountId: 011433970860
ContactId: 295f64e7-12c8-4506-9bd1-7c52eb083d69
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 819479 ms
Total Talk Time (AGENT): 276070 ms
Total Talk Time (CUSTOMER): 303235 ms
Interruptions: 2
Overall Sentiment: AGENT=0.5, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/28/295f64e7-12c8-4506-9bd1-7c52eb083d69_20250128T21:03_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from the product office to check claim status.
[AGENT][NEUTRAL] OK, I can help you, [PII]. What's the policy number?
[CUSTOMER][NEUTRAL] That's gonna be 02480036.
[AGENT][NEUTRAL] 02480036.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, and what's your phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] 73.
[AGENT][NEUTRAL] [PII]. OK, give me one second.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I wanna
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And what's the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Patient's first name is [PII] and the last name is.
[CUSTOMER][NEUTRAL] [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] OK, and you said that you're checking claim status?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] All right, we can help you. What's the policy number? I mean, I'm sorry, what's the date of service in charge?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] For the data service 44 2024 with the amount of $884 even.
[AGENT][NEGATIVE] Give me the total charge again a little slower please.
[CUSTOMER][NEUTRAL] 884.
[AGENT][NEUTRAL] $884.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] OK, thanks.
[AGENT][NEUTRAL] Give me one moment.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Alright, so I show the claim was not payable because office visits are not covered by the patient's policy. Um, this claim was received [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Uh, processed on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And let me know when you're ready for the claim number.
[CUSTOMER][NEUTRAL] Sure, one moment.
[CUSTOMER][NEUTRAL] Could you please repeat the claim date for me, [PII]?
[AGENT][NEUTRAL] I'm sorry, the received date is [PII].
[CUSTOMER][NEUTRAL] And the processed on [PII], next day, right?
[AGENT][POSITIVE] Uh-huh. Correct.
[CUSTOMER][NEUTRAL] Yeah, I'm ready for the claim number.
[AGENT][NEUTRAL] That is 346-901-1.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] You really think that.
[AGENT][NEUTRAL] Anything else and you can also check your status, [PII] on the online service center at [PII]. And did you have any other questions?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Nothing. And could you please spell out your name just for my documentation purpose.
[AGENT][NEUTRAL] Mhm, which you will use as your uh reference for today's call [PII], first initial last name is [PII].
[CUSTOMER][NEUTRAL] [PII], right?
[AGENT][POSITIVE] Uh-huh. That is correct.
[CUSTOMER][NEUTRAL] And could you please send us a UB copy to our fax number?
[AGENT][NEUTRAL] Um, it's was actually faxed automatically once the claim is, uh, was processed, so it's now available to download on our online service center. I'll give you the web address and I can also help you create the account. Just let me know when you're ready.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Sure. And
[AGENT][NEUTRAL] It's already been mailed?
[CUSTOMER][NEUTRAL] Yes. Yes and
[AGENT][NEUTRAL] Are you ready for the web address?
[CUSTOMER][NEUTRAL] No, no, um, else, could you please send us the UB copy to my mail ID?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Could you please send the UV copy to my mail ID mail?
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] No we can't email it.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] But I can help you create an account to download it from our online service center.
[CUSTOMER][NEUTRAL] Sure. And could you please help me out?
[AGENT][NEUTRAL] OK, let me give you the address. You ready?
[CUSTOMER][POSITIVE] Yeah, I'm ready.
[AGENT][NEUTRAL] OK, it's [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] U R E D.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Dot
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Amm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Public
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And when you get to the home.
[CUSTOMER][NEUTRAL] I'm under the same page.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Yeah, I'm on the same page.
[AGENT][NEUTRAL] Are you on
[AGENT][NEUTRAL] You're on the home page it says online service center welcome.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, you would click to the right there's a log in and a new user tab you will click the new user tab.
[CUSTOMER][NEUTRAL] One moment.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, uh, I could see there that it was the newer.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Tab. Yeah, I could see here there was a new tab.
[AGENT][NEUTRAL] OK, click on the tab and then you're gonna select which role best describes you.
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] And for this one, we need to create to access, right?
[AGENT][POSITIVE] Yes, because it's a secured account.
[AGENT][NEUTRAL] So it's gonna require the the on this particular claim the provider's tax ID number that's on the claim that was sent to us and then also the the patient account number that was on the claim that was sent to us.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, uh.
[CUSTOMER][NEUTRAL] That I'm in the login page.
[AGENT][NEUTRAL] Right, so when you it ask you to describe the role that best or that the role that which one did you select?
[CUSTOMER][NEUTRAL] Yes. Yes.
[CUSTOMER][NEUTRAL] I'm a medical or dental provider.
[AGENT][NEUTRAL] And then when you click the next button where did it take you?
[CUSTOMER][NEUTRAL] Yes, that is tax ID.
[AGENT][NEUTRAL] OK, and what is the tax ID? Can you give me that out loud?
[CUSTOMER][NEUTRAL] Sure. Let me enter it.
[CUSTOMER][NEUTRAL] And after that, there will be a patient account number.
[AGENT][POSITIVE] I'm sorry? Yes.
[CUSTOMER][NEUTRAL] I need to
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] Sure. Then after click next, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Sure. And that was the
[AGENT][NEUTRAL] And I wanted to make sure that you're able to get in the account. So did you enter the tax identification number?
[CUSTOMER][NEUTRAL] Yes, yes, I have that. I'm there.
[AGENT][NEUTRAL] What number did you enter?
[CUSTOMER][NEUTRAL] That is [PII].
[AGENT][NEUTRAL] OK, and what did you enter for the patient account number?
[CUSTOMER][NEUTRAL] That is [PII].
[AGENT][NEUTRAL] OK, and then when you click the next button where does it take you?
[CUSTOMER][NEUTRAL] Yeah, that is create your account.
[AGENT][NEUTRAL] What does it take you? Oh, to create the account got it. OK, got it.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] For the username, we can't able to use the special any special character.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Say that again, I'm sorry.
[CUSTOMER][NEUTRAL] For the username, we can't be able to enter any special character.
[AGENT][NEUTRAL] Not for the user name, but it, it, you would need to, uh, the, the password will require the use of one character and one number and it should give you the criteria that's needed before the username you don't have to uh include a symbol or number.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] One.
[CUSTOMER][NEUTRAL] Mhm. Yes. Uh, I have opened and the portal is ready for.
[AGENT][NEUTRAL] OK, so you're, you're inside the portal?
[CUSTOMER][NEUTRAL] A and
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, give me 1 2nd.
[CUSTOMER][NEUTRAL] You.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so then you're gonna go to the claims dashboard.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And um.
[AGENT][NEUTRAL] There is a a quick access and that's by providing the claim number which is the one that I gave you, the patient's first name that you have and then the patient's date of birth that you should have. So enter that criteria and then click um.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Search, right?
[AGENT][NEUTRAL] The green button, search button. Mhm.
[CUSTOMER][NEUTRAL] Yes, I got the.
[AGENT][NEUTRAL] Did it populate the um ELB for you?
[CUSTOMER][NEUTRAL] Right now.
[CUSTOMER][NEUTRAL] One moment.
[AGENT][NEUTRAL] Oh OK.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] How are you doing today?
[AGENT][POSITIVE] I'm good. I'm good. How about yourself?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Yeah, I'm also doing great and thank you for asking though.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] 817587.
[CUSTOMER][NEUTRAL] 727.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] G3810875.
[CUSTOMER][NEUTRAL] 85
[CUSTOMER][NEUTRAL] Yes, uh, if you have the UB on my end.
[AGENT][NEUTRAL] Do you see it? OK. So that's, that's how you can, um, uh, uh, request a copy of the ELB.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] But in that scenario you would have to call us to get the claim number. Um, the other way to search is what where it says don't have an APL claim number um you can enter the patient's name.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It asks for the patient's uh date of birth.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm mhm.
[AGENT][NEUTRAL] Um, the last, the, the next criteria where it asks for the last four digits of the primary insured. Uh, sometimes providers have that, sometimes they don't.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And then the patient account number and the date of service.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] That's another way you can search for it.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] Perfect. And
[CUSTOMER][NEUTRAL] But the way
[CUSTOMER][POSITIVE] Thank you for your assistance. And could you please provide me the reference number for our conversation?
[AGENT][NEUTRAL] It's my name in today's date, [PII], and the first initial of my last name is [PII]. Anything else I can help out with today, [PII]?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][POSITIVE] Nothing and thank you for your assistance, [PII]. And it was nice talking with you. Have a great day. Take care. Bye for now.
[AGENT][POSITIVE] Absolutely, thank you for calling APL. Have a good day.