AccountId: 011433970860
ContactId: 48fa3d09-18e9-4663-9154-dbb6d0a37aa9
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 236130 ms
Total Talk Time (AGENT): 74524 ms
Total Talk Time (CUSTOMER): 117541 ms
Interruptions: 0
Overall Sentiment: AGENT=2.3, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/04/48fa3d09-18e9-4663-9154-dbb6d0a37aa9_20250304T16:47_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Uh, my name is [PII] and I'm calling from provider's office to check for claim status.
[AGENT][POSITIVE] OK, well, I'll be more than happy to help you with the claim status, [PII]. And may I have a good contact number in case we're disconnected and the policy number?
[CUSTOMER][NEUTRAL] Yeah, [PII]. And policy number, OK, let me pull up. Uh, policy number is 02462888.
[AGENT][NEUTRAL] Thank you for that. And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Uh, [PII] and date of birth is [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah
[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 and the total bills for the claim?
[CUSTOMER][NEUTRAL] Yes, it's [PII]. Uh, it seems there is that range and it will be charged on [PII] and the charge amount is $3,261 even.
[AGENT][NEUTRAL] OK, can you verify the name of the provider's office on the claim?
[CUSTOMER][NEUTRAL] Can I provide you the facility?
[AGENT][POSITIVE] Yes, that's what I'm asking for. Yes, ma'am, that's correct.
[CUSTOMER][NEUTRAL] Oh yeah. Yeah. It's Hillcrest Hospital South.
[AGENT][POSITIVE] Alright and thank you so much for verifying. I am showing that we received the claim.
[CUSTOMER][NEUTRAL] OK. Uh just give me a moment once I'll, uh, uh, sorry, let me note it down. Just give me a second.
[AGENT][NEUTRAL] [PII], OK.
[CUSTOMER][NEUTRAL] Uh, on [PII].
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yes, we received it on [PII].
[CUSTOMER][NEUTRAL] And then process on.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And that claim number is 348.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] 7347.
[CUSTOMER][NEUTRAL] I
[AGENT][NEGATIVE] And it was denied requesting the explanation of benefits from primary insurance.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][POSITIVE] OK, good enough.
[CUSTOMER][NEUTRAL] 4
[CUSTOMER][NEUTRAL] OK, uh, from.
[CUSTOMER][NEUTRAL] OK, primary insurance. OK, just to make sure that we have to submit primary UOB, am I right?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] OK. And then what's the timely filing for submitting primary?
[AGENT][NEUTRAL] Um, there's no filing for the, um, additional information. Once we receive it, we'll go ahead and continue processing.
[CUSTOMER][NEUTRAL] OK, just to make sure, uh, that mailing address is [PII]. Is this the mailing address?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] OK. Uh, may I know the uh call reference number?
[AGENT][NEUTRAL] So there's no call reference number, but you can use my name in today's date. The first initial of my last name is [PII].
[CUSTOMER][POSITIVE] OK, thank you so much. Bye bye.
[AGENT][POSITIVE] You're welcome and thanks for calling APL. Was there anything else I can assist you with today?
[CUSTOMER][NEUTRAL] Uh, no, no. Thank you.
[AGENT][POSITIVE] Alright, thanks for calling IPO bye bye.