AccountId: 011433970860
ContactId: 5791304f-e248-41fe-9e8f-eb2e1ea730c4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 193360 ms
Total Talk Time (AGENT): 98614 ms
Total Talk Time (CUSTOMER): 81573 ms
Interruptions: 2
Overall Sentiment: AGENT=0.6, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/03/5791304f-e248-41fe-9e8f-eb2e1ea730c4_20250103T20:59_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII]. I'm calling from the facility regarding claim status. Can you help me with that?
[AGENT][NEUTRAL] OK, [PII], you're needing claim status, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Yes, I can help you with that. And what is your callback number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you and how many claims do you have to check status on?
[CUSTOMER][NEUTRAL] Only one.
[AGENT][NEUTRAL] OK. And what is that member's policy number, please?
[CUSTOMER][NEUTRAL] 02372882 ML 7.
[AGENT][POSITIVE] Thank you. One moment.
[CUSTOMER][POSITIVE] Exactly
[AGENT][NEUTRAL] And any information [PII] that I provide for you today will be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] Thank you. And the date of service and total bill amount, please?
[CUSTOMER][NEUTRAL] 88.
[CUSTOMER][NEUTRAL] [PII] $7,986 even.
[AGENT][NEUTRAL] And you did say [PII]. Is that correct?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] You need to be uh this ID.
[CUSTOMER][NEUTRAL] It
[AGENT][NEUTRAL] OK, so this claim was received back on [PII], processed and denied on [PII].
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] The claim number is 347-8927.
[AGENT][NEUTRAL] And the denial remark on this claim, [PII] states to please provide copies of the explanation of benefits from the primary insurance carrier.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] We have already submitted you the primary UB on [PII]. I'm so.
[AGENT][NEUTRAL] We not.
[AGENT][NEUTRAL] The then
[AGENT][NEGATIVE] For whatever reason that was not received. No, ma'am, we haven't received that.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] The fax number is [PII], right?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] You have not received any OB?
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] We have not.
[CUSTOMER][NEUTRAL] No problem. We resubmit it. Is there any timely filing limit to resubmit it?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] There is not. You may send it to the same fax number attention claims, and if you need a copy of the explanation of benefits from APL, you may print that from our portal at [PII].
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] Can I have your name and a call reference number also?
[AGENT][NEUTRAL] You would use my name that I gave you along with today's date. And again, my name is [PII].
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Actually, it ends in an [PII]
[CUSTOMER][POSITIVE] Thank you so much, [PII]. Have a great day. Bye-bye.
[AGENT][POSITIVE] You're welcome. You too, [PII], and if that's all I can help you with, thank you.