AccountId: 011433970860
ContactId: 470b19ce-01c0-4060-8a93-fb6d7859f488
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 558830 ms
Total Talk Time (AGENT): 160475 ms
Total Talk Time (CUSTOMER): 128639 ms
Interruptions: 0
Overall Sentiment: AGENT=0, CUSTOMER=-0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/14/470b19ce-01c0-4060-8a93-fb6d7859f488_20250514T16:56_UTC.wav
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[AGENT][POSITIVE] Good Afternoon. Thanks for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Yeah, hi, [PII]. This is [PII] calling from provider office to check the claims.
[AGENT][NEUTRAL] OK, I can verify claim status for you. And [PII], what is the policy number, please?
[CUSTOMER][NEUTRAL] The policy number is
[CUSTOMER][NEUTRAL] 016484445.
[AGENT][NEUTRAL] OK, thank you. One moment.
[AGENT][NEUTRAL] And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] The callback number is [PII].
[AGENT][NEUTRAL] I'm sorry, what was the last four digits?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and the patient's name, date of birth?
[CUSTOMER][NEUTRAL] The patient's name is
[CUSTOMER][NEUTRAL] [PII] and the date is on [PII].
[AGENT][NEUTRAL] OK, thank you and what was the date of service and the amount of the charge?
[CUSTOMER][NEUTRAL] The rate of services on [PII], with the bill amount as $57,103 even.
[AGENT][NEUTRAL] OK, and what was the balance after primary?
[CUSTOMER][NEUTRAL] It's $500 even.
[AGENT][NEUTRAL] I'm sorry, how much?
[CUSTOMER][NEUTRAL] $500 even.
[AGENT][POSITIVE] OK, thank you one moment.
[AGENT][NEUTRAL] I don't show this claim has been received. Can you verify the mailing address it was submitted to?
[CUSTOMER][NEUTRAL] Mm, can you verify with the claim number?
[AGENT][NEUTRAL] What is the claim number?
[CUSTOMER][NEUTRAL] It's 347-442-3.
[AGENT][NEUTRAL] OK, so this was a date range claim?
[CUSTOMER][NEUTRAL] No, it's only [PII].
[AGENT][NEUTRAL] What
[AGENT][NEUTRAL] OK, well, the claim number you gave me shows the date ranged from [PII]. What's the name of the provider's office?
[CUSTOMER][NEUTRAL] The provider's office is Henrio Doctor's Hospital.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, I'm trying to claim processes need primary EOB.
[CUSTOMER][NEGATIVE] Sorry, come again.
[AGENT][NEUTRAL] The claim processed as needing the primary insurance EOB.
[CUSTOMER][NEUTRAL] Mhm. Yeah, OK. Can I get the, uh, when the claim was received and when it was denied?
[AGENT][NEUTRAL] Uh one moment.
[AGENT][NEUTRAL] Uh, the claim was received on [PII], processed on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, is there.
[CUSTOMER][NEGATIVE] And it was denied as need of primary.
[AGENT][NEUTRAL] Uh, we need primary EOB.
[CUSTOMER][NEUTRAL] Yeah. Uh, is there any, uh, flight number or mailing address to send it?
[AGENT][NEUTRAL] Uh, fax number [PII].
[CUSTOMER][NEUTRAL] Uh, yeah, upon checking on my end, uh, we have already submitted the primary UB to the fax number that you provided. Can you verify or double-check the claim form?
[AGENT][NEGATIVE] We have not received it.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, yeah, OK. And we'll send that again. Is there a time limit to send that?
[AGENT][NEGATIVE] No, there's no timely filing.
[CUSTOMER][NEUTRAL] Yeah, OK, OK, OK. And uh
[CUSTOMER][NEUTRAL] That's it. Can I get the call a friend?
[AGENT][NEUTRAL] Uh, you may use my name at today's date. We don't give reference numbers.
[CUSTOMER][NEUTRAL] OK, just a moment. I have another client.
[AGENT][NEUTRAL] For the same patient or a different patient?
[CUSTOMER][NEUTRAL] No, it's for different.
[AGENT][NEUTRAL] OK, one moment, please.
[AGENT][NEUTRAL] OK, what is the next policy number?
[CUSTOMER][NEUTRAL] The policy number is.
[CUSTOMER][NEUTRAL] 024
[CUSTOMER][NEUTRAL] 73,340.
[AGENT][NEUTRAL] Patient's name, date of birth?
[CUSTOMER][NEUTRAL] The patient's name is [PII] and the date of this on.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and what was the date of service and the amount of the charge?
[CUSTOMER][NEUTRAL] D of service is on [PII]. The the bill amount is $32,575 even.
[AGENT][NEUTRAL] Balance after primary.
[CUSTOMER][NEUTRAL] Yeah, it's $500 even.
[AGENT][NEUTRAL] OK, you said the data service is [PII]?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, I show this claim and process is needing primary uh EOB.
[AGENT][NEUTRAL] And then, uh, give me a moment.
[AGENT][NEUTRAL] OK one moment.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] OK, it looks like um it was received the second time it was processed as we are unable to accept assignment of benefits for the claim filed due to a discrepancy reported to us by the IRS that is in combination of the name and taxpayer, uh, taxpayer ID number on the account. Uh, the provider will have to call the uh contact the IRS website to have that issue with um.
[AGENT][NEUTRAL] Resolved
[AGENT][NEUTRAL] And once it's been resolved, we would need a copy of the updated information and the claim can be uh released be continue to be processed.
[CUSTOMER][NEUTRAL] Mhm. Yeah, OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, that's it. OK I can I get the call.
[AGENT][NEUTRAL] Uh, we don't get reference numbers. You may use my name in today's date, and is there anything else I can assist you with today?
[CUSTOMER][NEUTRAL] Mm, no, I think.
[AGENT][POSITIVE] OK, thanks for calling APL. Have a great day.
[CUSTOMER][POSITIVE] Yeah, you too. Have a good day bye.
[AGENT][NEUTRAL] Uh-huh.