AccountId: 011433970860
ContactId: 40f8dc52-c682-46bc-9ca2-fa134e119aed
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 333239 ms
Total Talk Time (AGENT): 111823 ms
Total Talk Time (CUSTOMER): 74929 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/19/40f8dc52-c682-46bc-9ca2-fa134e119aed_20250519T16:15_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], um, I got an EOB in the mail from you guys and I called the number on the back which was let me see what it said.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] That was from benefits and a card and he told me I needed to speak with you guys about the claim itself um it's saying the patient responsibility is the full amount of the claim, but then on the back it says that you're awaiting information to confirm eligibility and that you will continue to process your claim, so I'm just wondering what that means exactly.
[AGENT][NEUTRAL] OK, let's, let's look at that. Um, what's your name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and can I get a good call back [PII] in case we get disconnected?
[CUSTOMER][NEUTRAL] 7,704,381,520
[AGENT][NEUTRAL] What's your policy number?
[CUSTOMER][NEUTRAL] 02517650
[AGENT][POSITIVE] Alright, let's look that up for you.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Can you give me the I have 025.
[AGENT][NEUTRAL] 17,650.
[CUSTOMER][NEUTRAL] Yeah, correct, that's the policy number.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And can I get your full name and date of birth?
[CUSTOMER][NEUTRAL] For the patient or for me?
[AGENT][POSITIVE] I'm sorry for the patient.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And then.
[AGENT][NEUTRAL] And her date of birth.
[CUSTOMER][NEUTRAL] The date of birth on here. I'm gonna have to pull it up.
[CUSTOMER][NEUTRAL] OK, hold on one second.
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you so much.
[AGENT][NEUTRAL] And does it have a claim number?
[CUSTOMER][NEUTRAL] It does, it's 359-978-6.
[AGENT][NEUTRAL] On there? OK.
[AGENT][NEUTRAL] Alright, let's look that up.
[AGENT][NEUTRAL] OK, yeah, we did receive that claim on the [PII]. It was processed on the [PII].
[AGENT][NEUTRAL] Let me see.
[CUSTOMER][NEUTRAL] And one is down in here.
[CUSTOMER][NEUTRAL] That
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So this is just saying that for us to process this claim we will need to um get information from BI or benefits in a card um I'm showing that you're not because you're the you're from the provider correct?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Yeah, uh, it looks like we just gave you that to let you know that we are processing the claim and that we're waiting um from that benefits in a card.
[AGENT][NEUTRAL] And so it's, it's just letting you know that you, you have nothing else, I believe to do. It's, we're, we're waiting on information from them. So it hasn't been denied or paid yet. Um, it's not a denial.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so it's still processing.
[AGENT][NEUTRAL] Right, it's still processing it's just letting you know that it's not anything on your end we're now waiting for the other party's end.
[CUSTOMER][NEUTRAL] OK, and about how long will it take to hear back?
[AGENT][NEUTRAL] I typically suggest 7 to 10 business days. Um, I don't think it'll take that long, especially since we're on day 10 now.
[AGENT][NEUTRAL] So I would wait until the end of the week?
[CUSTOMER][POSITIVE] Got you.
[AGENT][NEUTRAL] And if you still don't hear anything back, go ahead and give us a call back.
[CUSTOMER][NEUTRAL] Or
[CUSTOMER][POSITIVE] OK awesome I will keep a look out for it thank you so much.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] OK, is there anything else I can help you with?
[CUSTOMER][NEUTRAL] No, ma'am, that'll be it.
[AGENT][POSITIVE] Alright, thank you for calling APL and have a great day.
[CUSTOMER][POSITIVE] You as well thank you.
[AGENT][NEUTRAL] Alright bye.