AccountId: 011433970860
ContactId: 4569faf5-99ea-408a-9f3f-26482f8dbf7a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 423279 ms
Total Talk Time (AGENT): 120805 ms
Total Talk Time (CUSTOMER): 207151 ms
Interruptions: 0
Overall Sentiment: AGENT=0.1, CUSTOMER=-0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/28/4569faf5-99ea-408a-9f3f-26482f8dbf7a_20250428T14:37_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII], and I am calling on a statement that I received from a medical provider, and I had phoned, uh, earlier on this, and apparently you guys had not received billing for this particular date of service.
[CUSTOMER][NEGATIVE] And I called my medical provider back and they're supposed to be contacting you to get you a copy or you know uh get that resolved so that you guys were able to pay that billing.
[CUSTOMER][NEUTRAL] I need to follow up on that and see if indeed they did phone or contact you folks with this uh.
[CUSTOMER][NEUTRAL] Billing to make sure that this gets handled.
[AGENT][NEUTRAL] OK. Do you have a phone number I can get in case we get disconnected I can call you back?
[CUSTOMER][NEUTRAL] Yeah, it's [PII].
[AGENT][NEUTRAL] And do you have your policy number?
[CUSTOMER][NEUTRAL] Uh, yes, that is you need the 02230090.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And what was your name?
[CUSTOMER][NEUTRAL] My name is [PII]. This is actually under my wife's name.
[AGENT][NEUTRAL] And you
[AGENT][NEUTRAL] And what's your date of birth?
[CUSTOMER][NEUTRAL] And her name is
[CUSTOMER][NEUTRAL] Her date of birth or mine?
[AGENT][NEUTRAL] Yours
[CUSTOMER][NEUTRAL] Mine is [PII].
[AGENT][NEUTRAL] Thank you, Mr. [PII], and you had uh wanted to see if they called?
[AGENT][NEUTRAL] To try to file, file the claim for you.
[CUSTOMER][NEUTRAL] Yeah,
[CUSTOMER][POSITIVE] Correct, yes.
[AGENT][NEUTRAL] OK, I can help you with that. Hold on just a moment. Let me look and see if they called.
[AGENT][NEUTRAL] And they would have called after you called on [PII].
[CUSTOMER][NEUTRAL] Uh, yes, on, on [PII], yes, they should have called after that or contacted you electronically. I don't know how they do their actual billing for you folks.
[AGENT][NEUTRAL] OK, hold on, let me see.
[CUSTOMER][NEUTRAL] The data service in question.
[AGENT][NEUTRAL] Let me see if we got a claim in. I don't see where we spoke to anybody on the phone after you called. Let me see if they just sent the claim in.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And that claim was on you, right?
[CUSTOMER][NEUTRAL] It was under my wife, [PII].
[AGENT][NEUTRAL] It was the claim on you or her.
[CUSTOMER][NEUTRAL] The claim is on her.
[AGENT][NEUTRAL] OK.
[AGENT][NEGATIVE] Uh, do not show where they've sent anything in.
[AGENT][NEUTRAL] Either the last thing we got was on [PII], so.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I guess I'm I'm trying to figure out.
[CUSTOMER][NEUTRAL] How to get this handled, um, can you check the data service and see if you guys, you apparently did not have this data service.
[CUSTOMER][NEUTRAL] Presented to you from them.
[AGENT][NEUTRAL] What's the date of service?
[CUSTOMER][NEUTRAL] Um, which was on [PII].
[CUSTOMER][NEGATIVE] They're sending me a bill for charges um.
[CUSTOMER][NEGATIVE] And there was no payment made by you folks on that day for the charges that they're sending me.
[AGENT][NEUTRAL] OK. Is this for the facility bill or a doctor's charge?
[CUSTOMER][NEUTRAL] This is an actual clinic charge. It's, it's listed under JRalo A R CEO is the provider.
[AGENT][NEUTRAL] The only thing we have for 124 is the facility bill.
[CUSTOMER][NEUTRAL] There's a
[CUSTOMER][NEUTRAL] Which is a hospital bill correct?
[AGENT][NEUTRAL] Right, mhm.
[CUSTOMER][NEUTRAL] $5000
[CUSTOMER][NEUTRAL] OK, you don't show any other billing for that date.
[AGENT][NEUTRAL] I do not.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So I don't know how to, how do I go about getting this taken care of?
[AGENT][NEUTRAL] Now you can file the claim yourself if you would like. You would just have to get the itemized bill.
[AGENT][NEUTRAL] That has procedure codes, diagnosis codes, and the charges on it.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And your explanation of benefits from your primary insurance.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, are you showing, no, you're not, you wouldn't be showing that because my primary insurance looks like they paid $279.09 and there's a balance of $69.77 was the one in question. Do you show any payments made for 6977?
[AGENT][NEGATIVE] I do not, not for that date of service.
[CUSTOMER][NEUTRAL] You do not OK alright well I guess I will get back a hold of them and see if I can get an itemized billing or see if I can get them to actually contact you for that data service.
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] Now are they able
[CUSTOMER][NEUTRAL] Are they they're able to actually just call with that data service correct?
[AGENT][NEUTRAL] Well, they would have to file the claim.
[AGENT][NEUTRAL] With us
[CUSTOMER][NEUTRAL] Is that normal electronically or is it, is it by phone or how do they do?
[AGENT][NEUTRAL] So
[AGENT][NEUTRAL] They don't do it by phone. It's either electronic, fax or mail.
[AGENT][NEUTRAL] Or we have an online service center where they can upload it to. That's the fastest way to get it to us.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and they would have that information on how to do that obviously.
[AGENT][NEGATIVE] Uh, that I'm not positive.
[CUSTOMER][NEUTRAL] OK, and uh, and who, who am I speaking with again?
[AGENT][NEUTRAL] This is [PII].
[CUSTOMER][NEUTRAL] [PII], OK.
[CUSTOMER][NEUTRAL] And is there is there a reference number on this call that I can give them or not?
[AGENT][NEUTRAL] We do not have reference numbers. You can use my name in toda[PII]'s date.
[CUSTOMER][POSITIVE] OK, I will give them a quick call and see if they can get this handled for me.
[AGENT][POSITIVE] Yes, sir. Thank you, Mr. [PII], for calling APL. You have a good day.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][POSITIVE] I appreciate it you too.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Bye bye.
[AGENT][NEUTRAL] Bye-bye.
[CUSTOMER][NEUTRAL] Bye bye.