AccountId: 011433970860
ContactId: 3c2dd239-8b22-4f9f-b9f2-493dc8fb4e53
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 766690 ms
Total Talk Time (AGENT): 311331 ms
Total Talk Time (CUSTOMER): 261197 ms
Interruptions: 1
Overall Sentiment: AGENT=1.4, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/30/3c2dd239-8b22-4f9f-b9f2-493dc8fb4e53_20250130T17:33_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], good morning. This is [PII] calling on behalf of Jefferson Medical Group calling for claim status. How are you doing today?
[AGENT][POSITIVE] I'm doing well, [PII]. Thank you for asking. And how are you today?
[CUSTOMER][POSITIVE] Uh, doing pretty good as well. Excited for a long weekend for me.
[AGENT][NEUTRAL] You have a long weekend?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][POSITIVE] Yeah, I'm gonna leave actually for next week.
[AGENT][POSITIVE] Oh, well, good for you. I'm excited for you.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] My pleasure to assist you, [PII]. What is a good callback number?
[CUSTOMER][NEUTRAL] Sure, it's [PII]. Direct and no extension.
[AGENT][NEUTRAL] Thank you. And what is the policy number for the patient?
[CUSTOMER][NEUTRAL] 02369768 M. like Mary L for Lima 8.
[AGENT][NEUTRAL] Thank you, [PII]. And what is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] I have you, sir. Um, I have here [PII] [PII].
[AGENT][POSITIVE] All right, thank you.
[CUSTOMER][NEUTRAL] And [PII], what's your last initial?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] And it would be my pleasure to assist you with that claim status, [PII]. What is the data service?
[CUSTOMER][NEUTRAL] It's of service 8924 total bill amount, it's gonna be
[CUSTOMER][NEUTRAL] 275.
[AGENT][NEUTRAL] All right, thank you. And again, what is the facility name?
[CUSTOMER][NEUTRAL] Kennedy Medical Group Practice, we are doing business for Jefferson Health.
[AGENT][NEUTRAL] Is it JNJ?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Business office.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] OK, great. Thank you.
[AGENT][NEUTRAL] Now I'm showing that we've received this claim several times.
[AGENT][NEUTRAL] The original claim we received on [PII].
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] And processed on [PII]. Well, let's see, bear with me just one sec. I'm sorry. Let me give you a better
[AGENT][NEUTRAL] You said 89.
[AGENT][NEUTRAL] Let me, let me do that again. We received this claim on [PII] and processed on [PII].
[AGENT][NEUTRAL] The claim was denied as office visits are not covered under the patient's plan.
[AGENT][NEUTRAL] And the
[CUSTOMER][NEUTRAL] All right.
[AGENT][NEGATIVE] G9919 is there was no charges, so it's not covered.
[AGENT][NEUTRAL] And I can provide that claim number if you'd like.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][POSITIVE] Go ahead, please, thank you.
[AGENT][NEUTRAL] The claim number is 349.
[AGENT][NEUTRAL] 496 8
[AGENT][NEUTRAL] Now we've received that claim again on
[AGENT][NEUTRAL] 12:10, that was processed and denied as a duplicate.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] So by the way, can we request for a copy of EOP for this one?
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] We actually have a provider portal.
[AGENT][NEUTRAL] At secured.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] Where you have 24/7 access to EOBs, claim status, and claim submission.
[AGENT][NEUTRAL] And that portal, Philip is a self-registration portal. You use the tax ID number and the patient's account number inbox 26 on the HIFA.
[AGENT][POSITIVE] If you would like, I can assist you with creating an account and getting that EOB. It's a lot quicker than requesting a fax.
[CUSTOMER][NEUTRAL] Mhm. OK.
[CUSTOMER][NEUTRAL] Would you be able to, for the meantime, would you be able, OK get those, uh, would you be able to fax it first and then uh for this, this is my person calling with you guys.
[AGENT][POSITIVE] OK, yeah, I can do that for you. Give me just a minute, OK?
[CUSTOMER][POSITIVE] Oh, OK. Thank you very much. Yeah.
[AGENT][POSITIVE] My pleasure. It'll take just a minute, so bear with me.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, by the way, the, uh, would you be able to fax it to our fax number?
[AGENT][POSITIVE] Yes, give me just one moment, and once I get this prepared, I will get that fax number and go ahead and send it for you.
[CUSTOMER][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] It just takes a minute, so bear with me.
[AGENT][NEUTRAL] And [PII], do you spell your name with one L or two L's?
[CUSTOMER][NEUTRAL] 1 L.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And I can put the facts to your attention.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, bear with me just a sec.
[AGENT][NEUTRAL] [PII], what is the fax number?
[CUSTOMER][NEUTRAL] Yeah, that's our group fax number attached to my name, [PII].
[AGENT][NEUTRAL] And just to verify that fax number, I am sending this to [PII]. Is that correct?
[CUSTOMER][POSITIVE] Yes, thank you very much.
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] [PII], that is on the way for you. Is there anything else I can help you with today?
[CUSTOMER][NEUTRAL] Yeah, I'm working on doing your, um, you mentioned that you were going to help me creating a
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] But
[CUSTOMER][POSITIVE] Yeah, I'm on here the step to actually.
[CUSTOMER][NEUTRAL] Providing tax ID right here. Online service center then step 2, sorry.
[AGENT][NEUTRAL] Mhm. So I can give you the patient account number when you get to that point so you don't have to look it up if you would like.
[CUSTOMER][NEUTRAL] Madental provider.
[CUSTOMER][NEUTRAL] OK. [PII]. Go ahead with the patient card number.
[AGENT][NEUTRAL] It's [PII] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] So it's [PII], yeah.
[CUSTOMER][NEUTRAL] All right, one moment, searching.
[CUSTOMER][NEUTRAL] There you go.
[CUSTOMER][NEUTRAL] Uh, username.
[AGENT][NEUTRAL] You will need to create a username and password.
[CUSTOMER][NEUTRAL] Would be OK if uh going to use my email as a username?
[AGENT][NEUTRAL] Yes, you may not want to use the app, but you can use your email.
[CUSTOMER][NEUTRAL] Uh, no special tractor.
[AGENT][NEGATIVE] Not for the username. You will need a lowercase and uppercase and symbol.
[AGENT][NEUTRAL] And one number for the password, but not for the username.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] No, for the username, do I need to have um some, you know, special character.
[AGENT][NEUTRAL] No, that's
[AGENT][NEUTRAL] The special character for the username.
[CUSTOMER][NEUTRAL] No, alright.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Right, my phone number.
[CUSTOMER][NEUTRAL] Tax phone.
[CUSTOMER][NEUTRAL] The primary phone number is this the one that I'm using right now? I can use this one.
[AGENT][NEUTRAL] Yes, that's fine.
[AGENT][NEUTRAL] You can.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][POSITIVE] Oh my God. Mhm. One moment, I'm so sorry for this one. This is my first time creating a new website actually.
[AGENT][POSITIVE] Take your time.
[AGENT][POSITIVE] Sure, no, you just take your time. I'd rather make sure that you get it successfully created.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Your account was created. Oh, OK.
[CUSTOMER][NEUTRAL] One moment.
[AGENT][NEUTRAL] So if you, if you go back in, I'll help you get that EOB from there as well. That way, you know how to navigate it.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] APL.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] APL or American Public Life. One moment.
[CUSTOMER][NEUTRAL] Uh, where is it? Where is it? OK, American Public Life.
[CUSTOMER][NEUTRAL] Meaning, uh.
[CUSTOMER][NEUTRAL] I'm almost done here. Sorry about this one.
[AGENT][POSITIVE] No, you just take your, like I said, you just take your time.
[CUSTOMER][NEUTRAL] OK. Thank you very much. OK, how about APL claim number patient claim where I can get the EOP here.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] So, if you have the claim number, you're going to go to option one under claims.
[CUSTOMER][NEUTRAL] Just from a reference.
[CUSTOMER][NEUTRAL] Option one for claims.
[AGENT][NEUTRAL] Mhm. Because you have the claim number, you're gonna put in, be able to put in the claim number.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] And you'll put in the, the name, of course.
[CUSTOMER][NEUTRAL] Uh, OK. Patient name.
[AGENT][NEUTRAL] The same number, patient's name and patient's date of birth.
[CUSTOMER][NEUTRAL] Is the whole name correct?
[AGENT][NEUTRAL] Just the first name.
[CUSTOMER][NEUTRAL] Just the first name. Patient date of birth, [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Searching.
[CUSTOMER][NEUTRAL] Um, is this the 189?
[CUSTOMER][NEUTRAL] OK, it's just the one.
[CUSTOMER][NEUTRAL] OK. Let me open here.
[CUSTOMER][NEUTRAL] OK. Give me a quick second.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Do you have any reference number for today?
[AGENT][NEUTRAL] It's gonna be my name and today's date.
[CUSTOMER][NEUTRAL] All right. Is your first name is like [PII]?
[AGENT][POSITIVE] It sure is perfect.
[CUSTOMER][NEUTRAL] Spelling like that.
[CUSTOMER][NEUTRAL] Yeah, OK.
[CUSTOMER][POSITIVE] Oh wow.
[CUSTOMER][POSITIVE] OK. Thank you very much, [PII]. It's my pleasure to speak with you.
[AGENT][NEUTRAL] Now, did.
[AGENT][NEUTRAL] Did you get that EOB from the portal?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Pretty quick, huh?
[CUSTOMER][POSITIVE] Mhm. Thank you very much for your help, actually.
[AGENT][NEUTRAL] Once she has that account.
[AGENT][NEUTRAL] My pleasure. Now you can also, if you don't have a claim number, you would use option 2, but we will need the last four of the social of the policyholder for option 2.
[AGENT][NEUTRAL] And then if you need to say submit a primary EOB or a claim document, you can uh you would use option 3 to submit a claim document.
[AGENT][POSITIVE] And all that is online. [PII], it's been such a pleasure to assist you and I hope you enjoy your weekend.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] You as well. Goodbye, [PII].
[AGENT][POSITIVE] Mhm. Bye, [PII]. Take care. Have a wonderful afternoon.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Bye bye.
[CUSTOMER][NEUTRAL] Mhm.