AccountId: 011433970860
ContactId: 587ce6e2-fc50-46f6-b0bf-01cfaf1a7d0b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 293760 ms
Total Talk Time (AGENT): 113337 ms
Total Talk Time (CUSTOMER): 143256 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/10/587ce6e2-fc50-46f6-b0bf-01cfaf1a7d0b_20250610T19:38_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] What's your name again, ma'am?
[AGENT][NEUTRAL] Um, it's [PII]. Um, it's spelled [PII] and my last initial is [PII].
[CUSTOMER][NEGATIVE] Ay, OK, thank you, Ay. I was just talking to [PII] and then you guys' phone system did something and I couldn't hear her anymore.
[CUSTOMER][NEUTRAL] Um, but I have a question on an EOB.
[CUSTOMER][NEUTRAL] That apparently you guys have a question on.
[AGENT][NEUTRAL] OK, yes, sir. I can assist you with claim status. Um, first, could I get your name and a good callback number?
[CUSTOMER][NEUTRAL] Yes, and it's ma'am. My name is [PII]
[CUSTOMER][NEUTRAL] Callback number is [PII].
[AGENT][NEUTRAL] You can. I'm sorry, [PII], we are having issues with our phone. Um, could I get your policy number, please?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, yes, 02573211.
[AGENT][NEUTRAL] Thank you. Now, please verify your date of birth and your mailing address.
[CUSTOMER][NEUTRAL] My date of birth is [PII]. My mailing address is [PII].
[AGENT][NEUTRAL] OK. And I'm showing that you don't have an email address on file. Would you like to add one?
[CUSTOMER][NEUTRAL] No, ma'am, I don't like doing anything medical online.
[AGENT][POSITIVE] OK. And yes, ma'am. How can I help you?
[CUSTOMER][NEUTRAL] OK, so I've got
[CUSTOMER][NEUTRAL] an EOB 33025.
[CUSTOMER][NEUTRAL] CS cardiology.
[CUSTOMER][NEUTRAL] Outpatients expense blah blah blah and on the back of it first it says the above reference claims appear to be a duplicate of a previously submitted expense. Now I've gotten that one before.
[CUSTOMER][NEUTRAL] Just saying that. Now this one says, please provide copies of your EOB from your primary insurance carrier.
[AGENT][POSITIVE] OK. Yes, ma'am. And um the provider of service also received an explanation of benefits. So what normally happens is that when the provider receives this notification, they also resubmit the claim with the requested documentation, which is the EOB from your primary insurance company for this service and we'll be able to get the claim processed and paid for you.
[CUSTOMER][NEUTRAL] OK, so I need to find out because I don't have an EOB for my primary at this point, um.
[AGENT][NEUTRAL] Right, but your um provider should have one. The doctor should have one from the primary insurance company.
[CUSTOMER][NEUTRAL] I got
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] This, this is probably from a hospital visit.
[CUSTOMER][NEUTRAL] When I went to the hospital.
[AGENT][NEUTRAL] Yeah, I'm showing that this particular claim are for the provider fees.
[AGENT][NEUTRAL] So this is for the doctor that you saw when you went to the hospital.
[CUSTOMER][NEUTRAL] Right through the hospital.
[CUSTOMER][NEUTRAL] I didn't see a cardiologist after that.
[CUSTOMER][NEUTRAL] All I did was see the, um, I, I went to the emergency room.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] And I saw one doctor there.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So I'm not quite sure.
[CUSTOMER][NEUTRAL] If they bill separately at the hospital or what, I don't.
[CUSTOMER][NEUTRAL] I'm not sure what to get here.
[AGENT][NEUTRAL] OK. If it, if this is for that [PII] visit, then that's what happened. Um, the we'll receive a bill from the hospital and this is the hospital from the doctor that you saw.
[CUSTOMER][NEUTRAL] OK, so you're saying the provider's gonna send this to you, not me?
[AGENT][NEUTRAL] Right, the provider will send it because they're the one who filed the claim. Um, we just sent you a copy of it just so you'll know what's going on.
[CUSTOMER][NEUTRAL] Oh, OK, OK.
[CUSTOMER][NEUTRAL] That's why I'm confused.
[CUSTOMER][NEUTRAL] All right, well, so I don't have to do anything on my end at this time.
[AGENT][NEUTRAL] Um, no, ma'am. If you'd like, you can contact the pro you can contact the provider and make sure that they resubmit your claim, um, along with the EOB, but um at this time, no, ma'am. We're just waiting to hear back from the provider.
[CUSTOMER][NEUTRAL] Correct?
[AGENT][NEUTRAL] So that we can get the claim paid.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right, well thank you so much.
[AGENT][NEUTRAL] OK. Is there anything else I can assist you with?
[CUSTOMER][POSITIVE] Not at this time. Thank you so much. Have a great day.
[AGENT][NEUTRAL] OK [PII]. You do the same, [PII]. Thank you for calling ATL. Mm bye. Mhm.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Uh huh bye bye.