AccountId: 011433970860
ContactId: 4bbbca64-a851-4967-99ba-922d5bb40653
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 323260 ms
Total Talk Time (AGENT): 114644 ms
Total Talk Time (CUSTOMER): 143031 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/13/4bbbca64-a851-4967-99ba-922d5bb40653_20250213T14:46_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][POSITIVE] Hi [PII] how you doing this morning?
[AGENT][POSITIVE] I'm good how are you?
[CUSTOMER][POSITIVE] I'm doing good, please, ma'am, I was hoping you could help me with claim status.
[AGENT][NEUTRAL] OK, and may I have your name please?
[CUSTOMER][NEUTRAL] Sure it's [PII].
[CUSTOMER][NEUTRAL] Last name initial is [PII]
[AGENT][NEUTRAL] OK, thank you [PII]. Thank you. And what is your call back number if we are disconnected? I'm sorry.
[CUSTOMER][NEUTRAL] OK, it's [PII] and that's direct.
[AGENT][NEUTRAL] OK, thank you. What is the policy number?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] It is.
[CUSTOMER][NEUTRAL] 2446538
[AGENT][POSITIVE] OK, thank you. I have that as 2446538. Thank you so much. And thank you and verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] Um [PII] Date of birth [PII].
[AGENT][NEUTRAL] Thank you. I have that number pulled up and again you call for claim says I can assist you. Um, what is the date of service and the charge amount please, [PII]?
[CUSTOMER][NEUTRAL] OK, the first he has 3, the first day of service is 5-17-2024 for $422.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] OK thank you one moment please.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 2
[AGENT][NEUTRAL] Can you verify the procedure codes billed please? I'm sorry.
[CUSTOMER][NEUTRAL] Sure, um, 850278303684448. I got it. I went on a little overboard with the 4s [PII] and 80061.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] OK, thank you, thank you.
[AGENT][NEUTRAL] OK
[AGENT][POSITIVE] OK, thank you so much for your patience. It shows that we received the claim. thank you, and we are requesting the explanation of benefits from the primary, and I do have that claim number for you.
[CUSTOMER][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, it is 348-5301.
[CUSTOMER][NEUTRAL] OK, and you're requesting the primary ELB from um Blue Cross.
[AGENT][POSITIVE] The primary you'll be yes ma'am.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and then the next day service for the same, um, Mr. [PII] uh 12-9-2024.
[AGENT][NEUTRAL] OK, and what is the total charge amount?
[CUSTOMER][NEUTRAL] Oh, you are. I'm sorry, uh, 198 on 1 and 79 on the other.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So he has 2 for that one day, correct? OK.
[CUSTOMER][NEUTRAL] To right mhm.
[AGENT][NEUTRAL] OK, so 198 and how much is the other?
[CUSTOMER][NEUTRAL] Uh, 7979.
[AGENT][NEUTRAL] 79. OK, thank you one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, we do not have those claims on file for the member.
[CUSTOMER][NEUTRAL] OK, and may I please have your payer ID just so that I can uh verify whether or not we sent it to because if not then it might have went by mail.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, our payer ID is 60801.
[CUSTOMER][NEUTRAL] 01 OK, and I would need to resubmit those.
[CUSTOMER][NEUTRAL] For 12 9.
[CUSTOMER][NEUTRAL] OK, and may I have a reference number for your help?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Uh, we do not provide reference numbers, uh, [PII], but you, no, no problem. You can use my name and today's date. My last initials [PII], and also, yes, ma'am, and also you can check claim status by visiting our secure portal at [PII].
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][POSITIVE] Oh, that's good.
[CUSTOMER][NEUTRAL] And you know I'm on the APL portal and there are times where I can see claims but when I put in his information this time and um it asks to use um.
[AGENT][POSITIVE] No problem.
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][POSITIVE] The last four of his social, member, uh, I mean our patient account number and I normally do. I did it the normal way, but no claims showed up, so that's why I gave you a call and I'm glad because that one was there. It actually was there.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Yeah, we appreciate that one thank you so much for that, Miss [PII] for trying.
[CUSTOMER][POSITIVE] OK thank you have a good day, [PII].
[AGENT][POSITIVE] You as well, [PII], thanks for calling APL bye bye.
[CUSTOMER][NEUTRAL] Bye bye.