AccountId: 011433970860
ContactId: 3daaf503-8403-46f6-883d-7b565d4f5d05
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 580159 ms
Total Talk Time (AGENT): 198024 ms
Total Talk Time (CUSTOMER): 258031 ms
Interruptions: 3
Overall Sentiment: AGENT=0.4, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/06/3daaf503-8403-46f6-883d-7b565d4f5d05_20250306T15:39_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, um, good morning. I'm calling for claim status.
[AGENT][NEUTRAL] OK, I can help you. Your name.
[CUSTOMER][NEUTRAL] My name is [PII]. It's spelled [PII]
[AGENT][POSITIVE] Thank you for for spelling that for me, and you pronounce it?
[AGENT][NEUTRAL] You, you're on.
[CUSTOMER][NEUTRAL] [PII], [PII]. You can call me [PII], my last name is fine.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] OK, OK, I'll call you [PII]. Thank you.
[AGENT][NEUTRAL] What's the policy number?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Um, I have here, hold on, um, 025.
[CUSTOMER][NEUTRAL] 05698, the letter M for Mary, L for Larry, and the number 7.
[AGENT][NEUTRAL] And what's a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. And what is the patient's name and date of birth, Ms. [PII]?
[CUSTOMER][NEUTRAL] [PII], um, date of birth is [PII].
[AGENT][NEUTRAL] Thank you for that information and we're checking claim status correct?
[CUSTOMER][NEUTRAL] Welcome.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Alright, if you can provide the data service in charge we can provide a status for you.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I have a data service [PII] for $228 even.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And what are the procedure codes on the claim or procedure code?
[CUSTOMER][NEUTRAL] 99232.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] I think you're secondary, so it should be a a uh crossover.
[AGENT][NEUTRAL] Mhm, we are secondary.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] Is this from physician practices?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, so I'm showing a payment of $60.86 was issued on uh.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] Uh, let me give you the claim number and then I'll give you the check number. The claim number is 356.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] 7431.
[AGENT][NEUTRAL] And the check number is 202.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] 9382.
[AGENT][NEUTRAL] And I'll check to see if it's the check number. Check number is 2029382.
[CUSTOMER][NEUTRAL] Can you repeat that? I'm sorry.
[CUSTOMER][NEUTRAL] Yes, please.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Was it a bulk check or just a single check? Single?
[AGENT][NEUTRAL] Single, single.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And the explanation of benefits is attached to the check.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] I have a question, um.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] Cause I went in the portal and I register it and nothing comes out, it tells me no claim found.
[AGENT][NEUTRAL] OK, so let's go back to the portal, um, and I wanna focus on the tax identification number that you entered and then the patient account number that you entered that might be.
[CUSTOMER][NEUTRAL] Like
[AGENT][NEUTRAL] So you were able, go ahead.
[CUSTOMER][NEUTRAL] OK, I'm on.
[CUSTOMER][NEUTRAL] I am, I'm logged in and I see claim status as quick access or don't have an APL claim number because I didn't have a claim number for the claim, so I used the, don't have a claim number.
[AGENT][NEUTRAL] OK, so now try using the claim number that was provided and see I think the quick access needs the claim number I think the patient's date of birth and first name I believe.
[CUSTOMER][NEUTRAL] Like
[CUSTOMER][NEUTRAL] Yes, and that's what I did, but let me check with the claim number, see.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And the date of birth.
[CUSTOMER][NEUTRAL] Yeah, so 0 claims found unless cause I register right now, you think it's.
[AGENT][NEUTRAL] Can you verify the tax ID number that you used to uh register and the patient account number on your claim that was used?
[CUSTOMER][NEUTRAL] I don't know.
[CUSTOMER][NEUTRAL] Bye bye.
[CUSTOMER][NEUTRAL] Let me, let me try one more time.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Because I use the check number back and I'm so sorry.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, OK, it did come out.
[AGENT][NEUTRAL] All right. What did you do differently?
[CUSTOMER][NEUTRAL] I just, I, I put the claim number, I, I put the check number by accident.
[AGENT][NEUTRAL] Oh, I got you. Alright, OK, so you do see the ELB?
[CUSTOMER][NEUTRAL] Yes, I, I clicked on it. I'm trying to see if I can download it.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, this is, it says the amount paid $60 they completed 224, 25.
[CUSTOMER][NEUTRAL] So yeah.
[CUSTOMER][NEUTRAL] OK, download it. I see it here.
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] Um, cause I have a few claims of the page and that's why I was trying to do it online.
[AGENT][NEUTRAL] Oh yeah, so
[CUSTOMER][NEGATIVE] But I was having a hard time.
[AGENT][NEUTRAL] So you basically just need the claim number I think for each date of service.
[CUSTOMER][NEUTRAL] Yes, I have an old plane too.
[AGENT][NEUTRAL] What's the data service?
[CUSTOMER][NEUTRAL] It's, it's from 9-10-2024.
[CUSTOMER][NEUTRAL] For.
[AGENT][NEUTRAL] Let me see.
[CUSTOMER][NEUTRAL] For 1000.
[CUSTOMER][NEUTRAL] $662.
[AGENT][NEUTRAL] You said 1,662?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, let me see.
[AGENT][NEUTRAL] And it is for one.
[CUSTOMER][NEUTRAL] Yes, same patient.
[AGENT][NEUTRAL] Is it the same? OK.
[AGENT][NEUTRAL] Alright, so now I'm not showing a September [PII] data service received.
[CUSTOMER][NEUTRAL] OK, uh, if anything, I'll resend it or I'll look into it more, because I know the, the first insurance, the primary insurance is denying a cold.
[CUSTOMER][NEUTRAL] For a bundle, so I'm not sure that's why it didn't go over. I'm not sure.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I gotta look into it.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] If not, I'll just reset it, resend it with the UOB.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] OK, that sounds good.
[AGENT][NEUTRAL] And did you have another claim?
[CUSTOMER][NEUTRAL] OK, the.
[CUSTOMER][NEUTRAL] Yes, I have.
[CUSTOMER][NEUTRAL] Other than those two that I gave you, I have 4 more for the same patient.
[AGENT][NEUTRAL] OK, give me the dates of service uh for each.
[CUSTOMER][NEUTRAL] Um, this one is [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] For.
[CUSTOMER][NEUTRAL] For $58.
[AGENT][NEUTRAL] And the next one?
[CUSTOMER][NEUTRAL] Um, [PII] for $29.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, 2 [PII] for $58.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And 2 [PII] for $449.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So let's see.
[AGENT][NEUTRAL] On the 29 data service for 58, what's the procedure code?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] 93,010.
[AGENT][NEUTRAL] OK, so that claim number.
[CUSTOMER][NEUTRAL] There's 2 of them, same procedure.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So that that claim number is 356.
[AGENT][NEUTRAL] 7441.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And let me look for 212.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] I'm not showing the [PII] data service.
[AGENT][NEUTRAL] I'm not showing the [PII] date of service or the [PII].
[AGENT][NEUTRAL] Date of service.
[AGENT][NEUTRAL] For one.
[CUSTOMER][NEUTRAL] OK, should I, uh, resend those?
[AGENT][NEUTRAL] Yeah, you'll need to in order for us to review them since we've not received them.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so 212, 211, 218 not on fire.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Let me see something.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Hold on
[CUSTOMER][NEUTRAL] OK bye bye.
[CUSTOMER][NEUTRAL] OK, that's. Alright, perfect. Um, before we go, can I have a reference number for the call, please?
[AGENT][NEUTRAL] You'll use my name and today's date as your reference. It's [PII] First initial and last name is [PII]. And did you have any other questions, Ms. [PII], I can help out with today?
[CUSTOMER][POSITIVE] No, that's all. Thank you so much for your time and your help.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] You're welcome and thank you for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Uh bye-bye.