AccountId: 011433970860
ContactId: 5819d158-4c09-479b-915c-46b222458f2d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 208940 ms
Total Talk Time (AGENT): 61057 ms
Total Talk Time (CUSTOMER): 126679 ms
Interruptions: 0
Overall Sentiment: AGENT=0, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/02/5819d158-4c09-479b-915c-46b222458f2d_20250502T17:11_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I'm calling from a provider's office, [PII]. Um, I have a question for you. I came across an account that's a pretty old account. I was working on.
[CUSTOMER][NEUTRAL] Uh, the account because, uh, another, uh, person in my other department billed it to the wrong insurance, um, plan. They shouldn't have billed it it's too old. So I'm looking at the account and I'm noticing that we send the bill to the patient multiple times, and I don't know if you can check to see if back in [PII] this patient was covered under you.
[AGENT][NEUTRAL] OK. Do you have the policy number?
[CUSTOMER][NEUTRAL] Um, I, I'm not sure. Let's see, um, what it, what it is is they have this Medicaid replacement plan, uh, Blue Choice Medicaid, and Blue Choice Medicaid provided a, a number, uh, provided your American American public life and, um, and an ID number looking like this. I don't know if this is it. It's 022.
[AGENT][NEUTRAL] Um
[CUSTOMER][NEUTRAL] 00240
[AGENT][NEUTRAL] And what was that patient name and date of birth?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK. Do you have her date of birth?
[CUSTOMER][NEUTRAL] Oh sorry. Uh, yes, [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so it looks like, so yes, she was covered from [PII].
[AGENT][NEUTRAL] Um, but this is like a limited hospital indemnity plan. Let me see if she has.
[CUSTOMER][NEUTRAL] OK, I have a
[CUSTOMER][NEUTRAL] Oh, so it's not me is it medical? Coverage medical or no?
[AGENT][NEUTRAL] It it does it's just very limited. What kind of benefits were you looking at to submit for?
[CUSTOMER][NEUTRAL] It was a, it was a 911 emergency transport, ambulance transport. It's ALS2 emergency.
[AGENT][NEUTRAL] OK, let me see.
[AGENT][NEUTRAL] OK, let me see if there's any ambulance benefit. I don't think there is, but let me double check.
[CUSTOMER][NEUTRAL] Yeah, no, and, and one thing also I was wondering um.
[CUSTOMER][NEUTRAL] It's too late anyway to bill, right?
[AGENT][NEGATIVE] No, we are, um, these are supplemental policies, so there's no timely filing.
[CUSTOMER][NEUTRAL] OK, so, so basically I can, I can send you the bill and you guys will process the claim.
[CUSTOMER][NEUTRAL] If, if, if you, if you, if you tell me he has covered benefit, I mean, I'll wait for you to say that.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah, let me
[AGENT][NEUTRAL] Yeah, let me look that up. Uh, not a guarantee of payment basic outline of the policy. Um, on this policy, let's see.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] I don't see any ambulance benefits by ground or air.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK, so I'm, I'm figuring that's probably why um the patient needed to update her.
[CUSTOMER][NEUTRAL] Um, her information with the state and she didn't do that.
[CUSTOMER][POSITIVE] Because they still show that she has this as her primary insurance, medical insurance, so if she did that, yeah, so she, um, OK. All right, well, what's your name again? Thank you so much for helping me.
[AGENT][NEUTRAL] Oh yeah.
[AGENT][NEUTRAL] Uh, my name is [PII].
[CUSTOMER][POSITIVE] Thank you [PII] have a great day.
[AGENT][POSITIVE] Thank you for calling APL you as well bye bye.
[CUSTOMER][NEUTRAL] Bye.