AccountId: 011433970860
ContactId: 480d2824-8e6a-4c41-99cc-805387857ac8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 260709 ms
Total Talk Time (AGENT): 102300 ms
Total Talk Time (CUSTOMER): 90938 ms
Interruptions: 1
Overall Sentiment: AGENT=1.1, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2024/12/31/480d2824-8e6a-4c41-99cc-805387857ac8_20241231T21:48_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from the provider's office to check on a claim status.
[AGENT][POSITIVE] OK, I'll be more than happy to help you with the claim status, [PII], and how many claims do you have in total today?
[CUSTOMER][NEUTRAL] Just one.
[AGENT][NEUTRAL] OK, may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII] Direct line.
[AGENT][NEUTRAL] I'm sorry, can you repeat that slowly, please? [PII]?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] Sure. That is 02549585 M as in Mike, L as in Lima, 7.
[AGENT][NEUTRAL] Thank you for that. And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] [PII] and the date of birth is on [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And may I have the date of service for the claim you'd like me to check on?
[CUSTOMER][NEUTRAL] February 20, 2024.
[AGENT][NEUTRAL] And the total bills?
[CUSTOMER][NEUTRAL] Just a moment.
[CUSTOMER][NEUTRAL] Yeah, the total bill amount is $49,647 even.
[AGENT][NEUTRAL] Thank you for that. And you said this was [PII]?
[CUSTOMER][NEUTRAL] Yes, I do have a claim number here. If you want me to give that, I can give you that.
[AGENT][NEUTRAL] OK, what claim number is that?
[CUSTOMER][NEUTRAL] 353-261-1
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEUTRAL] And could you please tell me your name?
[AGENT][NEUTRAL] Hold on one second. My name is [PII] [PII]. This is a different policy number. Hold on one moment.
[AGENT][NEUTRAL] OK, so this is processed under policy number 2069982. Hold on one moment, let me pull that policy so I can get to the claim.
[AGENT][NEUTRAL] OK, and what questions did you have in reference to the claim?
[CUSTOMER][NEUTRAL] Uh, I have a correspondence stating that you need the primary will be.
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] But we have already sent the facts. I want you to know whether you have received it or not.
[AGENT][NEGATIVE] Um, no, we have not received anything since [PII].
[CUSTOMER][NEUTRAL] [PII]. OK. Uh, so, uh, could you please tell me when this claim was received on?
[AGENT][NEUTRAL] Yes, this claim was received on [PII].
[CUSTOMER][NEUTRAL] OK. And when was this processed?
[AGENT][NEUTRAL] This is the only thing we've processed for the member. um November, it was processed on the same day.
[CUSTOMER][NEUTRAL] Process done?
[CUSTOMER][NEUTRAL] OK. [PII].
[CUSTOMER][NEUTRAL] So, could you please tell me, uh,
[CUSTOMER][NEUTRAL] The fax details like uh how do you want us to send this EOB?
[AGENT][NEUTRAL] Um, you can fax it to us. Our fax number is [PII].
[AGENT][NEUTRAL] We also have a payer ID if you'd like to send it electronically.
[AGENT][NEUTRAL] And that's 60.
[CUSTOMER][NEUTRAL] OK. Uh, just
[CUSTOMER][NEUTRAL] Yeah, go on.
[AGENT][NEUTRAL] The payer ID is 60801.
[CUSTOMER][NEUTRAL] OK, that's uh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, [PII]. Thank you, thank you. And uh
[AGENT][NEUTRAL] You're welcome, [PII]. Is there anything else I can assist you with today?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] No, uh, what, what I needed.
[AGENT][POSITIVE] OK, well, thanks for calling APL. I hope you have a great day and [PII].
[CUSTOMER][POSITIVE] [PII].
[AGENT][POSITIVE] Thank you. Bye-bye.