AccountId: 011433970860
ContactId: 52bea008-864e-48df-94df-6a39d036dcdf
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 236740 ms
Total Talk Time (AGENT): 95129 ms
Total Talk Time (CUSTOMER): 108263 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/12/52bea008-864e-48df-94df-6a39d036dcdf_20250312T20:10_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Very good afternoon. My name is [PII]. I'm calling you from products office to check on a claim status. Can you please help me with that?
[AGENT][NEUTRAL] Yes, I can verify claim status for you. And you say your name is [PII]?
[CUSTOMER][POSITIVE] That's correct.
[AGENT][NEUTRAL] OK, and [PII], what is that policy number, please?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, the policy number is 01780690 Mike Lima 8. And can you also please spell out your name?
[AGENT][NEUTRAL] Sure, it's [PII].
[AGENT][NEUTRAL] And [PII], do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] Mhm, the good callback number is [PII]. It's a direct line.
[AGENT][NEUTRAL] Thank you, and verify the patient's name, date of birth.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah. Patient name is [PII].
[CUSTOMER][NEUTRAL] [PII]. And the date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you. And you say you're calling for claim status, correct?
[CUSTOMER][POSITIVE] That's correct.
[AGENT][NEUTRAL] OK, and what was the date of service and the amount of the charge?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Date of service is [PII] and the bill charges are $16,719 even.
[AGENT][NEUTRAL] OK, and what was the balance after primary insurance has processed the claim?
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] One moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So, uh, basically, it's a follow-up call. One of the reps stated that I need primary insurance, EOB, uh, so, previously,
[CUSTOMER][NEUTRAL] Uh, primary, you'll be.
[CUSTOMER][NEUTRAL] Send through fax.
[AGENT][NEUTRAL] OK, so you don't have the amount because we initially process it as needing primary EOB, correct?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, um, while I'm looking at up claim information, let you know we do have an online service center where providers can check claim status as well as print out the EOB. That site is at secured. AM as in [PII].
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] And
[AGENT][NEUTRAL] And I show that claim looks like it was received twice, initially processed as needing primary EOB the second time it was processed as a duplicate.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So, uh, have you guys received, uh, PE, uh, PDOB?
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] We have not received the primary EOB, so that is needed.
[CUSTOMER][NEUTRAL] OK. Can you please provide me the fax number to uh send the primary OB?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Thank you for that information. And can you please provide me received it and deny it?
[AGENT][NEUTRAL] The 1st time or the 2nd time?
[CUSTOMER][NEUTRAL] First one, first time.
[AGENT][NEUTRAL] Uh, received [PII] process on [PII].
[CUSTOMER][NEUTRAL] [PII], OK.
[CUSTOMER][NEUTRAL] And.
[CUSTOMER][NEUTRAL] Yeah, the, can you please verify the claim number 3513902?
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] OK. Thank you for that information.
[CUSTOMER][NEUTRAL] Yeah, nothing else needed, and can you also please forward me the call reference number?
[AGENT][NEUTRAL] Uh, we don't give call reference numbers. If you like, you may use my name and a date.
[AGENT][NEUTRAL] And [PII], is there anything else I can assist you with today?
[CUSTOMER][NEUTRAL] Yeah, it's
[CUSTOMER][POSITIVE] No, nothing else, and that's all for the day. Thanks for asking, by the way.
[AGENT][POSITIVE] You're welcome. Thank you for calling APL. Have a great day.
[CUSTOMER][NEUTRAL] You too. Bye-bye.
[AGENT][NEUTRAL] Bye.