AccountId: 011433970860
ContactId: 475bcc81-eafe-4e75-adc6-82b12ad4a391
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 333290 ms
Total Talk Time (AGENT): 105067 ms
Total Talk Time (CUSTOMER): 197874 ms
Interruptions: 2
Overall Sentiment: AGENT=1.8, CUSTOMER=1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/06/475bcc81-eafe-4e75-adc6-82b12ad4a391_20250506T13:04_UTC.wav
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[AGENT][NEUTRAL] Thanks for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, you said your name is [PII]?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII], I apologize.
[AGENT][POSITIVE] How can I assist you today?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK. Um,
[CUSTOMER][NEUTRAL] Appreciate it. I apologize about that. I'm calling from Medical University Hospital Authority. My name is [PII]. I'm calling to see what is needed to get this claim processed because you're, you'll be explaining one thing about what our posting department put in the system is a different thing. So I just need to confirm what's needed.
[AGENT][NEUTRAL] Can I have your callback number and the spelling of your name?
[CUSTOMER][NEUTRAL] Not a problem. Callback number is gonna be [PII]. My spelling of my name is [PII]. Last [PII] is [PII]. And can I have your last initial please?
[AGENT][NEUTRAL] Thank you, [PII]. What is the policy number of the member?
[CUSTOMER][POSITIVE] You're welcome.
[CUSTOMER][POSITIVE] I appreciate that.
[AGENT][NEUTRAL] That you're calling your Fox status for.
[CUSTOMER][NEUTRAL] OK. I
[CUSTOMER][NEUTRAL] Hope this is the policy number and you're, you're fine. Um I hope this is the policy number because they pull up on your website um 02569249.
[AGENT][NEUTRAL] And what is the member's name and date of birth?
[CUSTOMER][NEUTRAL] Not a problem. Her name is [PII], [PII].
[AGENT][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] Do you have a claim number from that EOB?
[CUSTOMER][NEUTRAL] Uh, and that's another thing they put in the incorrect information for the EOB, so let me look at your EOB.
[CUSTOMER][NEUTRAL] Uh, we have, they just, I don't know what happened. I'm not gonna make an excuse, um, for this on your EOB it says claim number is 3593637.
[AGENT][NEUTRAL] For data service [PII] for a facility charge.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][POSITIVE] That is correct, $286 even, yes ma'am.
[AGENT][NEUTRAL] We're requesting the EOB from the primary insurance company.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Good oh goodness, they placed here that you're requesting for medical records.
[AGENT][NEUTRAL] What?
[CUSTOMER][NEUTRAL] Yeah, yeah.
[AGENT][NEUTRAL] It literally says we're requesting a primary ELB from the detailed ELB from the primary insurance company because this is the gap insurance.
[CUSTOMER][NEUTRAL] Yes, correct, it says here on your second line page too it says please provide copies of your explanation of update, which is understandable, but as I say, would they put it.
[CUSTOMER][NEGATIVE] So I don't know where to get that from. It says incomplete invalid in um document, medical records, notes, and charts needed.
[AGENT][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] And then your claim number in our system that I had to call and verify we have 02569249.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] I'm not sure where it come from, but.
[AGENT][NEUTRAL] Let me see, make sure that.
[CUSTOMER][POSITIVE] Me either. That's why I say thank you for sending us the EOB. Thank you. I'm happy to even attached it so I can tell you what the correct claim number is, mhm, yeah.
[AGENT][NEUTRAL] It's probably the primary's claim number, but we just need the EOB because this policy is a gap insurance.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And it assists the deductible co-pay and co-insurance to the primary, but we have to have the primary EOB in order to process the claim.
[CUSTOMER][POSITIVE] Perfect. OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Um, how can I submit this?
[AGENT][NEUTRAL] Um, you can submit it electronically by fax, mail, whichever you prefer.
[CUSTOMER][NEUTRAL] OK, can I have the fax number?
[AGENT][NEUTRAL] Yeah, let me give it to you.
[CUSTOMER][NEUTRAL] And I appreciate it and I did check to see if that was the primary claim number. The numbers are 15 letters with 6 alpha. I don't know where that came from in their system.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] It is 1877.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] 3659423 that's 18773659423 attention claims department.
[CUSTOMER][POSITIVE] Perfect. So I have [PII] attention claims department.
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][POSITIVE] Perfect, perfect. And the last thing I will need if you do not, oh.
[AGENT][NEUTRAL] Is there anything else that I can assist you with?
[CUSTOMER][NEUTRAL] Yeah, the last thing I would need is just a reference number for our call, and we are done.
[AGENT][NEUTRAL] We don't provide those unfortunately so you can use my name in today's date as a reference.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] I appreciate that thank you very much you have a wonderful great day.
[AGENT][POSITIVE] Thanks for calling APL. You have a great one as well, [PII], and don't let this the billing department stress you.
[CUSTOMER][NEGATIVE] Oh trust me, they're not, they're not.
[CUSTOMER][POSITIVE] I ain't let nobody scratch him, but the good man upstairs, and he don't scratch you. He help you.
[AGENT][POSITIVE] And he's not even gonna scratch you. He's not gonna put no more than you can bear.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Say that again.
[AGENT][POSITIVE] But thank you for calling APL and you have a great day today. It was a pleasure speaking with you.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][POSITIVE] You too, have a blessed one. Thank you.
[AGENT][POSITIVE] Thank you. Goodbye.
[CUSTOMER][NEUTRAL] Bye.