AccountId: 011433970860
ContactId: 374147d8-137e-4e4d-a0c5-c97391db44dd
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 451700 ms
Total Talk Time (AGENT): 168006 ms
Total Talk Time (CUSTOMER): 141032 ms
Interruptions: 4
Overall Sentiment: AGENT=0.4, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/28/374147d8-137e-4e4d-a0c5-c97391db44dd_20250128T19:23_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII] from Paris facility looking on glimps. How you doing?
[AGENT][NEUTRAL] I'm doing fine, but I'm so sorry. What did you say your name was?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII]. Is that correct?
[CUSTOMER][POSITIVE] That's correct.
[AGENT][NEUTRAL] OK, [PII]. Yes, and you're needing claim status. Is that also correct?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Sorry, what was that?
[AGENT][NEGATIVE] We don't have a good connection, [PII]. You're breaking up.
[CUSTOMER][NEUTRAL] What, what about now?
[AGENT][NEUTRAL] Mm, no, sir. It's still a lot of static on the line.
[CUSTOMER][POSITIVE] I think it's better now.
[AGENT][NEUTRAL] Did you
[AGENT][NEUTRAL] Did you say that you were needing claim status?
[CUSTOMER][POSITIVE] That's correct.
[AGENT][POSITIVE] Yes, I can help you. And what is your callback number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And how many claims, [PII], do you have to check status on?
[CUSTOMER][NEUTRAL] We do have one claim for today?
[AGENT][NEUTRAL] One, is that correct?
[CUSTOMER][POSITIVE] That's correct.
[AGENT][NEUTRAL] OK. And what is your patient's policy number?
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] OK the member's policy number what I have here in my this.
[CUSTOMER][NEUTRAL] 02344311 M. [PII] L Lima, number 8.
[AGENT][POSITIVE] Thank you. One moment.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] And [PII], any information that I do provide for you today will be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] With royal.
[CUSTOMER][NEUTRAL] month, the date of birth is [PII]. That's.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Just one moment, [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And what is the date of service and total bill amount, please?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] The service here.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII] for $1,504 even.
[AGENT][NEUTRAL] 1502. Is that correct?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 1504
[AGENT][NEUTRAL] 04
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][POSITIVE] Thank you. One moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so this claim was received on 9-19-2024.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] It was processed and denied on 9-24-2024. The claim number is 3508702.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] How do you spell your name?
[AGENT][NEUTRAL] Pardon me?
[CUSTOMER][NEUTRAL] How do you spell that?
[AGENT][NEUTRAL] How do you spell what?
[CUSTOMER][NEUTRAL] Your name?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And this claim was denied and the reason for the denial states to please provide copies of the explanation of benefits from the primary insurance carrier.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK, you mean that the claim is denied requesting for
[AGENT][NEUTRAL] Requesting primary insurance company's explanation of benefits be sent.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Hello
[CUSTOMER][NEUTRAL] This is the 3
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] And if you need a copy of this explanation of benefits, [PII], from APL with the remarks on it, you may go to our portal at [PII] and print the print that explanation of benefits for us for this claim number.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, how do we need to submit the primary UV?
[AGENT][NEUTRAL] But you also need to submit the primary insurance explanation of benefits for your data service.
[CUSTOMER][NEUTRAL] Yes, how do we need to submit it through the fax number, mailing address, or we need to resubmit the claim, uh, with the primary UVR app?
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] No, we just need the primary insurance company's explanation of benefits, and that may be faxed or mailed. The fax number is [PII]. Attention claims.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Um
[AGENT][NEUTRAL] And our mailing address is [PII].
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Bear with a minute.
[CUSTOMER][NEUTRAL] Your what?
[AGENT][NEUTRAL] Excuse me, the [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] The zip code is [PII].
[CUSTOMER][NEUTRAL] I just
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And is there anything else that I can help you with, [PII]?
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] Did you say no?
[CUSTOMER][NEUTRAL] Yes, so what's gonna be the caller reference number?
[AGENT][NEUTRAL] My name and today's date?
[CUSTOMER][NEUTRAL] OK. Once the uh primary will be submit the claim will be automatically processed towards payment, right?
[AGENT][NEUTRAL] No, sir, that's not what I said. It will be reviewed.
[CUSTOMER][POSITIVE] Alrighty then, they got it, thanks.
[AGENT][NEUTRAL] Yes,