AccountId: 011433970860
ContactId: 3c2eac1e-ef94-4ac8-8291-b9037315b29f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 528140 ms
Total Talk Time (AGENT): 181700 ms
Total Talk Time (CUSTOMER): 168796 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/07/3c2eac1e-ef94-4ac8-8291-b9037315b29f_20250207T13:28_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey, [PII]. This is [PII] from provider's office, checking on the claims.
[AGENT][POSITIVE] I'm so sorry. What did you say your name was?
[CUSTOMER][NEUTRAL] [PII] uh-huh.
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you, [PII]. And your callback number?
[CUSTOMER][NEUTRAL] OK, so the callback number.
[CUSTOMER][NEUTRAL] One minute, I just have an updated one.
[CUSTOMER][NEUTRAL] Here it is. [PII].
[AGENT][POSITIVE] OK, thank you. And how, oh, I'm sorry, go ahead.
[CUSTOMER][NEUTRAL] And the extent
[CUSTOMER][NEUTRAL] So the extension is [PII].
[AGENT][NEUTRAL] OK, thank you. And how many claims, [PII], do you have to check status on today?
[CUSTOMER][NEUTRAL] Uh, let's just have a look at it. Well, I just have only one claim, uh, [PII].
[AGENT][NEUTRAL] Yes, ma'am. I can help you with that. And what is the member's policy number?
[CUSTOMER][NEUTRAL] OK yeah
[CUSTOMER][NEUTRAL] So the policy number I have is 02150688.
[AGENT][NEUTRAL] OK, thank you. One moment, please.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And then, any information that I do provide for you today would be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, the patient's name is [PII] on.
[CUSTOMER][NEUTRAL] Yes, it is [PII]. and the date of birth is [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And the date of service please and total bill amount.
[CUSTOMER][NEUTRAL] OK. So, that is [PII].
[CUSTOMER][NEUTRAL] And the total charge amount is 250, uh.
[CUSTOMER][NEUTRAL] $2.
[AGENT][NEUTRAL] 252. Is that correct?
[CUSTOMER][NEUTRAL] Yes. Yes, $252.00.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, so we did receive this claim. This claim was received on 6-27-2024.
[AGENT][NEUTRAL] It was processed and denied on [PII].
[AGENT][NEUTRAL] And the reason for the denial is that we are in need of the primary insurance company's explanation of benefits.
[AGENT][NEUTRAL] For further review.
[CUSTOMER][NEUTRAL] OK. So do you have, OK. Do you have any, uh, patient's primary UB details, I mean primary patient's primary care, UB, is there any update from patient's end?
[AGENT][NEGATIVE] We have not received the primary insurance company's explanation of benefits for this data service.
[CUSTOMER][NEUTRAL] Tan. OK, so.
[AGENT][NEUTRAL] We need that to be sent. Mhm.
[CUSTOMER][NEUTRAL] OK. Got it. And uh
[AGENT][NEUTRAL] And if you need a copy.
[CUSTOMER][NEUTRAL] Is it possible for you
[AGENT][NEUTRAL] If you need a copy of this explanation of benefits.
[CUSTOMER][NEUTRAL] Go ahead, [PII].
[AGENT][NEUTRAL] You may print that from our portal now that you have the claim number by going to secured. [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. So can you please provide me the claim number?
[AGENT][NEUTRAL] 347-579-3
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And is it not possible for you to send a copy of yourB to my fax number?
[AGENT][NEUTRAL] Can you not print it?
[CUSTOMER][NEGATIVE] And now, because I don't have an access to the portal.
[AGENT][NEUTRAL] OK, it is a self registering portal. [PII], so you can create your own username and password. I will send you this one to give you time to get your portal set up, so just give me time to get this information loaded.
[CUSTOMER][POSITIVE] Oh, that's good.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So, can you just repeat that link?
[AGENT][POSITIVE] Secured.
[CUSTOMER][NEUTRAL] Let me make a note of the link.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Are you ready for the portal?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][POSITIVE] It is secured.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]. OK, got it.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. Got it. And how about the call reference number?
[AGENT][NEUTRAL] Yes, ma'am. It is my name along with today's date. So you do not need for me to fax this to you. Is that correct?
[CUSTOMER][NEUTRAL] Uh-huh. But if you have an if you have an access of uh sending me the U be through fax, that would be great. Or else, uh, I would put an effort of, uh, checking it in the portal.
[AGENT][NEUTRAL] Or you do.
[AGENT][NEUTRAL] Just one moment and I'll go, as I said, I'll fax you this one to give you time to get the portal information pulled up.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So just a moment, it's still loading.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] OK. Thank you so much.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] And does it need to be put to your attention or is that not necessary?
[CUSTOMER][POSITIVE] Yes, attention would be uh perfect because
[AGENT][NEUTRAL] I'm sorry, attention what?
[CUSTOMER][NEUTRAL] Uh, I can
[CUSTOMER][NEUTRAL] Uh, attention.
[CUSTOMER][NEUTRAL] To my name?
[AGENT][NEUTRAL] OK, just one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And what is your fax number, please, [PII]?
[CUSTOMER][NEUTRAL] So, the fax number I have is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK. Again, that is [PII]. Is that correct?
[CUSTOMER][POSITIVE] You're right.
[AGENT][NEUTRAL] OK, so that has been faxed to you, so provided that it will go through, you should be receiving that very shortly.
[CUSTOMER][POSITIVE] OK, thank you so much for that.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Is there anything else that I can help you with today, [PII]?
[CUSTOMER][POSITIVE] Mm, no, [PII], that is actually what you asked me and thank you so much. Uh, have a great day. Bye-bye.
[AGENT][POSITIVE] Well, yes, ma'am. You're very welcome and thank you again for calling APL. I hope you have a very nice day also.
[CUSTOMER][POSITIVE] And a happy weekend.
[AGENT][POSITIVE] Happy weekend to you as well. Thank you.
[CUSTOMER][NEUTRAL] Bye.
[AGENT][NEUTRAL] Uh-huh. Bye-bye.