AccountId: 011433970860
ContactId: 30e9a71a-331c-4799-a833-abd9f5655754
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 568820 ms
Total Talk Time (AGENT): 141117 ms
Total Talk Time (CUSTOMER): 118860 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=-0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/20/30e9a71a-331c-4799-a833-abd9f5655754_20250220T14:41_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from provider office checking for the claim status. Your name?
[AGENT][NEUTRAL] Sure. My name is [PII]. That's [PII]. Last initial [PII]. And may I have the spelling of your name?
[CUSTOMER][NEUTRAL] Yes, [PII] and last initial is [PII].
[AGENT][NEUTRAL] I'm sorry, can you spell that one more time?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII], OK, thank you, and may I have a callback number just in case we get disconnected, Miss [PII]?
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] [PII]. This is the direct line.
[AGENT][NEUTRAL] OK. All right. And may I have the patient's policy number, Mrs.
[CUSTOMER][NEUTRAL] Policy number is 02.
[CUSTOMER][NEUTRAL] 270516 M as in Mary, L as in Lima 7.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] What's the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Name is, it's [PII]. Date of birth is [PII] sorry, [PII].
[AGENT][NEUTRAL] May I have the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] Yeah, it's 1111 24.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] But the amount is $29,083 even.
[AGENT][NEUTRAL] OK. [PII], the amount of $2029,0083 even, is that correct?
[CUSTOMER][NEUTRAL] Yes, 83.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Dollars even.
[AGENT][NEUTRAL] Alright, and for sure, for future you can check claim status online through our website at [PII] and that's just optional. And one moment, let me see if I can find your claim. May I place you on hold for a minute?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Yes, please. You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Thank you for holding and being patient for me, Miss [PII]. OK, so it looks like um we received this claim on [PII], and we process on [PII]. We're needing the primary EOB to continue the processing of this claim.
[CUSTOMER][NEUTRAL] Claim number?
[AGENT][NEUTRAL] That is 355-7538.
[CUSTOMER][NEUTRAL] Just who is the primary for this one?
[AGENT][NEUTRAL] Um, let me see one moment.
[AGENT][NEUTRAL] Let me get that for you.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Whose?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEGATIVE] Sir, your voice is breaking.
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] OK. A
[CUSTOMER][POSITIVE] [PII]. Thank you.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] What is the member ID for the need?
[AGENT][NEUTRAL] Oh, we don't have that information. We can only see the name of the main hold of the primary insurance, but we don't have additional information.
[CUSTOMER][NEUTRAL] OK. Can you please provide me the effective date for the admit?
[AGENT][NEUTRAL] We don't have that information. You'll have to get in contact with [PII]. We only see the name of the primary.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh oh, just a second.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] But the.
[CUSTOMER][NEUTRAL] We.
[CUSTOMER][NEUTRAL] Confirm that I have the member ID it's A as in Alpha, 6,009,867,000. Is it correct?
[AGENT][NEUTRAL] I do apologize. I cannot confirm that information. We don't have it. You have to contact [PII].
[CUSTOMER][NEUTRAL] OK, uh, how can we submit the primary I have mailing address?
[AGENT][NEUTRAL] Mailing address for APL is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the zip code is [PII].
[AGENT][NEUTRAL] You can also fax it. Do you need the fax number?
[CUSTOMER][NEUTRAL] No need.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Just a second.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. And you need the primary, you'll be with the correct name also the uh UB04 form.
[AGENT][NEUTRAL] Um, we just need the primary ELB. That's all we need right now to process the claim.
[CUSTOMER][NEUTRAL] OK, thank you. I don't need the uh UB 04 form.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] We haven't.
[CUSTOMER][NEUTRAL] OK, got it.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, I'll just need the call reference number.
[AGENT][NEUTRAL] We don't have reference numbers. You can use, you can use my name in today's statement, Miss [PII].
[CUSTOMER][NEUTRAL] For this one.
[CUSTOMER][POSITIVE] OK. Well, so, uh, I'm done with this. Thanks for assisting me. Have a wonderful day. Goodbye for now.
[AGENT][POSITIVE] You as well. OK. Have a good day. Bye-bye.
[CUSTOMER][NEUTRAL] Yeah, that day.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Mhm