AccountId: 011433970860
ContactId: 4f21cfc5-b940-469e-b59a-08c834f8e19b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 701479 ms
Total Talk Time (AGENT): 144922 ms
Total Talk Time (CUSTOMER): 120789 ms
Interruptions: 1
Overall Sentiment: AGENT=1.3, CUSTOMER=-1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/15/4f21cfc5-b940-469e-b59a-08c834f8e19b_20250115T17:41_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from provider's office to check on a claim status. Hi.
[CUSTOMER][POSITIVE] Good afternoon.
[AGENT][NEUTRAL] Hi, sure.
[AGENT][NEUTRAL] Yes, Ms. [PII], I can assist you with claim status. May I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Sure, my callback number is [PII] and it's a direct line.
[AGENT][NEUTRAL] Thank you and may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Yeah, patient's policy number is.
[CUSTOMER][NEUTRAL] 01940661
[AGENT][NEUTRAL] OK, thank you. One moment.
[CUSTOMER][NEUTRAL] And can I have your name? Could you spell out your name?
[AGENT][NEUTRAL] Sure. My name is [PII]. That's [PII].
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yes, last initial [PII].
[CUSTOMER][POSITIVE] Got it. Thank you, sir, nice name.
[AGENT][NEUTRAL] You're welcome. Thank you. And may I have the name and date of birth of the patient, Mr?
[CUSTOMER][NEUTRAL] Yeah, the patient's name is [PII] [PII].
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] OK, thank you. And what is the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] The date of those would be [PII].
[CUSTOMER][NEUTRAL] To the charge amount of $2,699.20.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] OK, so I'm looking for a claim from [PII], the amount of $2,699.20. All right. OK, let me see if I can find this claim for you. For future, you can check claim status online through our website at [PII], and that's just optional. Um, let's see, [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Hey you know what.
[CUSTOMER][POSITIVE] Secure.
[CUSTOMER][NEUTRAL] The
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright. OK, looks like we have processed this claim 3 times and the most recent ones are duplicate, and the original one is needing the explanation of benefits from the primary insurance. It looks like we have not received that explanation of benefits as of today.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And we still need the explanation of benefits.
[CUSTOMER][NEUTRAL] But you are the primary.
[CUSTOMER][NEUTRAL] But you are the primary for the patients.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] We're not.
[AGENT][NEUTRAL] Um, the primary is going to be, one moment.
[AGENT][NEUTRAL] Aetna, Aetna is the primary.
[CUSTOMER][NEUTRAL] Give me one moment.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Do you have any Vietnam member ID?
[AGENT][NEUTRAL] No, we don't have that information. We can only see the name of who's the major medical or your primary insurance, but we don't have the details.
[CUSTOMER][NEUTRAL] Oh, sure, can I have the claim number because I don't have the claim we have only the duplicate ones.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, the original one is 328-7859.
[CUSTOMER][NEUTRAL] 3287859
[AGENT][POSITIVE] Mhm, that's correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So can I have the year of the copy.
[AGENT][NEUTRAL] What is the fax number?
[CUSTOMER][NEUTRAL] The fax number is [PII].
[CUSTOMER][NEUTRAL] [PII] and attention to my name.
[AGENT][NEUTRAL] OK, so that's [PII].
[CUSTOMER][POSITIVE] [PII]. Perfect.
[AGENT][NEUTRAL] OK. And how do you spell your name?
[CUSTOMER][NEUTRAL] It's [PII] and my last initial is [PII].
[AGENT][NEUTRAL] OK. OK, um, bear with me. Let me go ahead and send this out to you while I got you on the line. I'm gonna put you on a brief hold.
[CUSTOMER][NEUTRAL] Oh sure take your time uh and I just need to. You are on hold.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you for holding and being patient for Ms. [PII]. OK, I went ahead and send that over to you. Should be there in a few minutes. Is there anything else I'm gonna help you with today?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh sure.
[CUSTOMER][NEUTRAL] Oh, that's it. Can I have the call reference number?
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in today's date if you will.
[CUSTOMER][POSITIVE] Oh sure, thank you so much, so.
[AGENT][POSITIVE] You're welcome and thank you for calling APL. Have a good day.
[CUSTOMER][POSITIVE] Have a good day. Bye-bye.
[AGENT][POSITIVE] Thank you. Bye-bye.