AccountId: 011433970860
ContactId: 4887f33f-0cee-489a-867f-851fd0c97162
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 283329 ms
Total Talk Time (AGENT): 66304 ms
Total Talk Time (CUSTOMER): 161573 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/07/4887f33f-0cee-489a-867f-851fd0c97162_20250507T13:47_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], how are you? Good morning. My name is [PII], and I'm just calling to see if you guys uh have a claim on file. Are you guys, well, I have a question. Are you guys supplemental for, for me?
[AGENT][NEUTRAL] Yes, we are.
[CUSTOMER][NEUTRAL] OK, no, don't, because I have a claim for this from United Healthcare, and you guys don't cover that because it is, it, it is not from Medicare, it's from United Healthcare.
[CUSTOMER][NEGATIVE] So it doesn't cover.
[AGENT][NEUTRAL] Uh, do you have a policy number or?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, I do. You want it? you want the policy. It is 945137.
[CUSTOMER][NEUTRAL] For [PII].
[CUSTOMER][NEUTRAL] But I think, uh, you know, and he has a primer.
[AGENT][NEUTRAL] Are you with the provider's office?
[CUSTOMER][NEUTRAL] Yes, he has a primary United Healthcare. So, it doesn't cover, it, it will not apply, you guys are secondary. He will be responsible for the balance.
[AGENT][POSITIVE] Great.
[AGENT][NEUTRAL] Right, we're secondary, so we pick up after primary processes the claim.
[CUSTOMER][NEUTRAL] Regardless of if, if it's United Healthcare.
[AGENT][NEGATIVE] Yeah, it doesn't matter. That's not relevant, yeah.
[CUSTOMER][NEUTRAL] Oh, OK, OK, cause, uh, OK, then we'll, I'll continue.
[AGENT][NEUTRAL] OK. Uh, do you have a good callback number, [PII]?
[CUSTOMER][NEUTRAL] 2, yeah, [PII].
[AGENT][NEUTRAL] And what provider are you with?
[CUSTOMER][NEUTRAL] Moses Con physician Services, Moses Con Health.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And so do you need his benefits and eligibility or?
[CUSTOMER][NEUTRAL] Uh, no, I have a, I have a claim on file. I'm just going to see if you guys have the claim for United Healthcare for date of service [PII] for the amount of $175 Medi uh United Healthcare pay and process, leaving the remaining balance of $50.
[AGENT][NEUTRAL] OK, it was 175, is that right?
[CUSTOMER][NEUTRAL] Yes, it was, yeah, 175.
[AGENT][NEUTRAL] And 1227 24, correct?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] Uh, yes, looks like we received that on [PII].
[AGENT][NEUTRAL] And it looks like.
[AGENT][NEUTRAL] So we actually did deny it because they have a maximum of 3 visits per calendar year, um, and that had already been met at this point.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, do you have a new, do you have a new bill that you can fax me?
[AGENT][NEUTRAL] Sure, what's your fax?
[CUSTOMER][NEUTRAL] Or can you send it by the, or you can, if not, you, you can also send it to the same address on file which is [PII]. You can mail it back.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] I can
[AGENT][NEUTRAL] I can fax it. Do you have a fax number?
[CUSTOMER][NEUTRAL] OK. Yes, it is. Give me a second. I so much. It is [PII]. I'm gonna repeat the number. [PII].
[CUSTOMER][NEUTRAL] And attention on [PII].
[AGENT][NEUTRAL] OK, I'll
[CUSTOMER][NEUTRAL] And then dash.
[CUSTOMER][NEUTRAL] I'm gonna, yeah, cause he's like dash Alpha Peter, AB 1174175051.
[AGENT][NEUTRAL] OK, I'll get that faxed over. It just takes about 5 minutes.
[CUSTOMER][POSITIVE] I'll take your time.
[CUSTOMER][POSITIVE] Thank you so much. Uh, let me see if I have more, more.
[AGENT][NEUTRAL] Is there any
[CUSTOMER][NEUTRAL] Uh, more, um,
[CUSTOMER][POSITIVE] wait, let me see if I have more. I think you guys are the only ones. Yeah, you guys are the only ones. Thank you so much. Can I have a name and a reference code?
[AGENT][NEUTRAL] That's my name is [PII], and then today's date with my name is the reference number.
[CUSTOMER][NEUTRAL] Thank you, [PII], how do you spell your name? I'm, I'm very bad. [PII].
[AGENT][NEUTRAL] Um it's [PII]
[CUSTOMER][POSITIVE] [PII]. OK. Thank you.
[AGENT][POSITIVE] OK, thanks for calling APL. I hope you have a good day.
[CUSTOMER][POSITIVE] Mm OK, thank you.