AccountId: 011433970860
ContactId: 2fed5dcd-8867-4161-a949-9d1dcdef385b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 333399 ms
Total Talk Time (AGENT): 92439 ms
Total Talk Time (CUSTOMER): 123654 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/27/2fed5dcd-8867-4161-a949-9d1dcdef385b_20250127T15:31_UTC.wav
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[AGENT][POSITIVE] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey, [PII], this is [PII] in the cancer queue.
[AGENT][NEUTRAL] Hey, how are you?
[CUSTOMER][NEUTRAL] Yeah, I have a provider on the line.
[CUSTOMER][NEUTRAL] And it's for policy 02427279.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And um I'm reviewing claim 347777777.
[AGENT][NEUTRAL] OK, let's see. Give me just a second, let me get everything pulled up here.
[AGENT][NEUTRAL] OK. What's going on with it?
[CUSTOMER][NEUTRAL] OK, so the this denied as a duplicate. Um, the prior claim, which is 346-5976 denied because they're asking for the itemized billing, they submitted the UV.
[CUSTOMER][NEUTRAL] Um, and it denied as a duplicate, so I'm sending her over, so, um, you all can let her know what, what is missing.
[AGENT][NEUTRAL] OK, uh, what is the provider's name?
[CUSTOMER][NEUTRAL] Her name is [PII]. The callback number is [PII]. Her [PII] [PII].
[AGENT][NEUTRAL] OK, you can send her through.
[CUSTOMER][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Hey [PII], this is [PII]. How are you?
[CUSTOMER][NEUTRAL] Hi [PII], uh, it's actually [PII].
[AGENT][NEUTRAL] Oh, [PII], OK.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Um, hi.
[AGENT][NEUTRAL] Let's see here. I understand you have a question um about a claim, is that correct?
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Yeah, um, so what happened was when we originally submitted this claim, um, it was back on [PII], well, we had a letter or EOB stating that they needed an itemized statement with the claim. So when we submitted the claim with the itemized statement, it denied duplicate, so I didn't know if the original claim can be processed since the itemized had been received or.
[CUSTOMER][NEUTRAL] If one of these can be processed because that's what it was asking for, I didn't know what the status was for this claim for this patient.
[AGENT][NEUTRAL] OK, give me just a second. I'm trying to.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I'm trying to locate this original claim.
[CUSTOMER][NEUTRAL] OK, yeah, it was submitted on [PII] from our end.
[AGENT][POSITIVE] OK, here we go. I got it.
[CUSTOMER][NEUTRAL] 24, OK.
[AGENT][NEUTRAL] Uh, let's see here. Let me pull up this original claim and kinda see what's going on with it.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] Well, if I can hit the right buttons, I can get it pulled up.
[CUSTOMER][NEUTRAL] It's Monday. I get it.
[AGENT][NEUTRAL] Oh, it's definitely a Monday.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Um
[AGENT][POSITIVE] My goodness.
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] OK, so let's see.
[AGENT][NEUTRAL] So it was it's the service 513-528.
[AGENT][NEUTRAL] On the original claim.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And then the second claim, let me pull up this image.
[AGENT][NEUTRAL] Um, let's see here.
[AGENT][NEGATIVE] Bear with me for just a second. I have just multiple screens I have to go to.
[AGENT][NEUTRAL] OK, so I'm gonna go in and get this climbing processed for you. I'm unsure.
[AGENT][NEUTRAL] Why it was not like this, so we're gonna get this claim. Give me, um, by the end of the day it'll be reprocessed.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK perfect and [PII], would there be a reference call um number for
[CUSTOMER][NEUTRAL] Our conversation so I can note the account.
[AGENT][NEUTRAL] It will be my name, [PII], with the first initial to my last name [PII], and today's date.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK perfect I appreciate your help [PII] thank you.
[AGENT][POSITIVE] You're welcome. Is there anything else I can help you with today?
[CUSTOMER][NEUTRAL] No, that's all I needed.
[AGENT][POSITIVE] OK, well thank you for calling APL and I hope you have a great day.
[CUSTOMER][POSITIVE] Thank you. You too. Bye.
[AGENT][NEUTRAL] All right, bye bye.