AccountId: 011433970860
ContactId: 3b4bd562-6618-4384-b7fa-d5a6ce17626d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 361339 ms
Total Talk Time (AGENT): 109161 ms
Total Talk Time (CUSTOMER): 77451 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/10/3b4bd562-6618-4384-b7fa-d5a6ce17626d_20250210T19:37_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, yes, [PII], my name is [PII], and I'm calling from Vanderbilt Medical Center calling to discuss a claim.
[AGENT][POSITIVE] OK. Well, I'll be more than happy to assist you with the claim, [PII]. And may I have a good contact number in case we're disconnected and then the policy number?
[CUSTOMER][NEUTRAL] Yes, call back number begins in area code [PII] and member policy number that we have on file is 02148767M as in Mary, L as in Lima 8.
[AGENT][POSITIVE] Thank you. Hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Yes, member's first and last name is [PII] and their date of birth is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you for that. And may I have the date of service or the claim number for the claim you like me to take a look at?
[CUSTOMER][NEUTRAL] Yes, it's for data service.
[CUSTOMER][NEUTRAL] [PII], for total charge of 1900 and.
[CUSTOMER][NEUTRAL] $17.78.
[AGENT][NEUTRAL] And that was [PII]?
[CUSTOMER][POSITIVE] That is correct.
[AGENT][NEUTRAL] Alright, and do you mind if I place you on just a brief hold while I locate the claim?
[CUSTOMER][POSITIVE] Sure, thank you.
[AGENT][NEUTRAL] You're welcome, hold on one moment.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Wow
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Thank you so much for holding. I apologize for that wait. So all the information provided is a verification of benefits, not a guarantee of payment. Um, so for the claim, I'm actually showing I received it on [PII].
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] And the claim number is 3557519.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And on [PII], the claim was denied requesting the explanation of benefits from primary insurance.
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] Requesting
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] And who do you guys have missed this primary?
[AGENT][NEUTRAL] I'm sorry.
[CUSTOMER][NEUTRAL] Who do you have listed as patient's primary insurance?
[AGENT][NEUTRAL] Um, let me see, hold on one moment.
[AGENT][NEUTRAL] I'm sorry, it keeps looping. Hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, Florida Blue.
[CUSTOMER][NEUTRAL] And that's as a um effective, you have one that was effective or when did you receive that primary?
[AGENT][NEUTRAL] Hold on 1 2nd.
[AGENT][NEUTRAL] And let me double check that because it's sticking, so I want to make sure this is the right. Hold on one moment.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Alright
[AGENT][NEUTRAL] 365 operating.
[AGENT][NEUTRAL] OK, yeah, I, it that was the, um, you can disregard the Florida Blue, my apologies. Their primary insurance is United Healthcare. Um, the United Healthcare is, has been active.
[AGENT][NEUTRAL] Since [PII], um, their policy with us, um, APL is second only to that UnitedHealthcare policy.
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] And and can I get the reference number?
[AGENT][NEUTRAL] So there's no um call reference number, but you can use my name in today's date. The first initial to my last name is [PII].
[CUSTOMER][POSITIVE] Thank you so much and I hope you have a great day.
[AGENT][POSITIVE] Thank you, do you also, and thanks for calling APL.
[CUSTOMER][NEUTRAL] All right.
[AGENT][NEUTRAL] Bye-bye.