AccountId: 011433970860
ContactId: 50f85b63-1e63-4448-9e0d-fa1c5595b821
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 335850 ms
Total Talk Time (AGENT): 108087 ms
Total Talk Time (CUSTOMER): 95278 ms
Interruptions: 0
Overall Sentiment: AGENT=2, CUSTOMER=1.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/22/50f85b63-1e63-4448-9e0d-fa1c5595b821_20250122T15:13_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you today?
[CUSTOMER][NEUTRAL] Good morning, [PII]. My name is [PII], and I'm calling from anesthesiology affiliate. Ms. [PII], I need your help. I need to verify claim status to discuss a claim. Uh, we received a denial claim, but I don't have the claim number, so I don't know what's going on.
[AGENT][POSITIVE] OK, yeah, I'd love to help you with that claim status today, Miss [PII]. Do you mind if I get a good call back number from you real quick?
[CUSTOMER][NEUTRAL] Yeah, you can call me uh [PII].
[AGENT][NEUTRAL] Thank you and the member's policy number?
[CUSTOMER][NEUTRAL] OK, it is uh 01997050, and that is for [PII]. Date of birth [PII].
[AGENT][POSITIVE] Alright, thank you.
[AGENT][NEUTRAL] And one moment please.
[AGENT][NEUTRAL] Alright, what is the date of service on the claim we wanna look at today?
[CUSTOMER][NEUTRAL] It was uh [PII] and you guys were secondary?
[AGENT][NEUTRAL] Yep, and the total bill amount?
[CUSTOMER][NEUTRAL] Well, it was for you guys $182 but um it was $11,050.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] And what is the name of the facility on file for this claim?
[CUSTOMER][NEUTRAL] Uh, Mr. [PII]. That is uh our tax ID number is [PII].
[AGENT][NEUTRAL] [PII] and I didn't catch the rest from there. I'm sorry.
[CUSTOMER][NEUTRAL] OK, let me repeat that. It's [PII].
[AGENT][POSITIVE] [PII], thank you.
[AGENT][NEUTRAL] OK, so it wasn't that one. Sorry, there's a couple different ones that it could have been and I'm just looking through them all to see which ones match.
[AGENT][POSITIVE] All right, perfect. I was able to locate that claim for you um it looks like on our side.
[AGENT][NEUTRAL] Sorry I have to go back to it. It looks like we received your claim on [PII]. It looks like the claim was processed [PII], and I do show your claim number listed as 3,449,310.
[CUSTOMER][NEUTRAL] Let me repeat that. So it is 344-9310.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK, OK, thank you.
[AGENT][NEUTRAL] Absolutely. And I do show that claim did deny. Um, the reason stating is please provide a copy of your explanation of benefits from your primary insurance carrier. So it looks like when we received that claim, we didn't have the major medical EOB to go with it.
[CUSTOMER][NEUTRAL] OK, and uh
[CUSTOMER][NEUTRAL] OK, just, uh, let me, is any way can I fax that to you guys or needs to be through the mail?
[AGENT][POSITIVE] Yeah, absolutely. You can fax it.
[CUSTOMER][NEUTRAL] OK, what is the fax number?
[AGENT][NEUTRAL] Yes, absolutely. It's going to be [PII].
[CUSTOMER][NEUTRAL] OK, I'm going to fax it right now. I, I know this is going to be timely friendly, but you know, we need that in order to go to the next step. OK, thanks.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, um, we don't have a timely filing limit, so it's OK.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Oh, it's it, oh good. And what is the reference number for my phone call, please?
[AGENT][NEUTRAL] Yes, absolutely. Reference number is going to be my name, [PII], first initial, last name, B like boy, and today's date.
[CUSTOMER][POSITIVE] OK, [PII], thank you so much for, for your help.
[AGENT][POSITIVE] Oh, it's my pleas
[CUSTOMER][POSITIVE] And have a wonderful
[AGENT][POSITIVE] You have a wonderful day too, Miss [PII]. Thank you so much for calling APL.
[CUSTOMER][POSITIVE] Thank you, bye-bye.
[AGENT][NEUTRAL] Bye bye.