AccountId: 011433970860
ContactId: 5c3a5f5c-9bb7-449a-9a8d-dccb5e4d2e37
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 340899 ms
Total Talk Time (AGENT): 166670 ms
Total Talk Time (CUSTOMER): 130085 ms
Interruptions: 1
Overall Sentiment: AGENT=2.3, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/25/5c3a5f5c-9bb7-449a-9a8d-dccb5e4d2e37_20250225T15:47_UTC.wav
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[AGENT][POSITIVE] Good Morning, thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], I need to follow up on a claim for a patient.
[AGENT][POSITIVE] It would be my pleasure to help you with that claim status. May I ask your name?
[CUSTOMER][NEUTRAL] My name is [PII], last initial [PII]
[AGENT][POSITIVE] Thank you, [PII] and what is a good callback number?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Thank you, [PII]. And what is the policy number for the patient?
[CUSTOMER][NEUTRAL] 01612924
[AGENT][NEUTRAL] And [PII], what is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Alright thank you and it would be my pleasure to assist you with that claim information. What is the date of service?
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] And the bill out, please, ma'am.
[CUSTOMER][NEUTRAL] $7,637.50.
[AGENT][NEUTRAL] And what is the name of the facility, please?
[CUSTOMER][NEUTRAL] Memorial Herman Health System.
[AGENT][NEUTRAL] Is that hospital as well? Memorial.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, got you. Thank you and I can help you with that claim status. Uh, we actually received that claim on 11-11-2024.
[AGENT][NEUTRAL] And it is, it was processed on [PII] and is pending for the primary EOB.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] We are secondary, and we're secondary to united.
[CUSTOMER][NEUTRAL] OK. We, we sent it with the primary maybe.
[CUSTOMER][NEUTRAL] It wasn't now, is there a claim number that
[AGENT][NEUTRAL] Yeah, the claim number is 352.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 9380.
[CUSTOMER][NEUTRAL] And is there a way can we fax the EOB to you or?
[AGENT][NEUTRAL] Absolutely, and you, you can fax it directly to our claims department. Now we don't need that UBO4 again since we already have it. So you can fax it reference in the policy number and the claim number 352.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 9380.
[CUSTOMER][NEUTRAL] I'm sorry.
[CUSTOMER][NEUTRAL] Can I find the fax number again? I totally, I don't know what I did.
[AGENT][POSITIVE] I don't even know that I gave you that fax number yet, so I think you're good.
[CUSTOMER][NEUTRAL] Oh, OK. Yes.
[AGENT][NEUTRAL] Yeah, yeah, I was just saying that you can just send the EOB reference in the claim number and policy number and our fax number.
[AGENT][NEUTRAL] Is 877.
[AGENT][NEUTRAL] 365.
[AGENT][NEUTRAL] 942 3.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So you were just giving me the claim number again. Oh my goodness, I'm sorry.
[AGENT][NEUTRAL] I was, yeah, I was just making sure you had the policy and claim number to reference for that fax.
[CUSTOMER][NEUTRAL] OK, so you don't you, uh, you don't have the primary EOB yet.
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] Right. OK. I was totally misunderstanding.
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] That's why I was confused while you.
[AGENT][NEUTRAL] I'm so sorry, yes, so we, the claim is still pending for that primary EOB and there's no time timely filing to submit that.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] OK, well, I will pull it and get it submitted, and you said that you need to reference the claim number and the policy number on the cover sheet.
[AGENT][POSITIVE] That's correct. That's correct. That's right.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. I can do that. I think.
[AGENT][NEUTRAL] Well, I, I might have, um, I was just going 90 did nothing too, and I apologize. That's one of my pet peeves is when people just start spitting out stuff and I can't keep up. And there I go, spit it out. I'm so sorry.
[CUSTOMER][POSITIVE] Well thank you so much.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][MIXED] It is OK. I, I don't know what happened. I kinda just kinda, nope, I wasn't getting through.
[AGENT][NEUTRAL] Well, you know what?
[CUSTOMER][NEUTRAL] I think maybe I need some more caffeine or something.
[AGENT][POSITIVE] I was just gonna say, I think I'm gonna make another pot of coffee for me.
[AGENT][NEUTRAL] You want some of my coffee?
[CUSTOMER][POSITIVE] Yes, please. Obviously, I need it. Thank you.
[AGENT][NEUTRAL] I'll share.
[AGENT][POSITIVE] There are days like that for sure.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Yes, all right, I think I have everything and get it submitted. Um, did I ask for a reference number?
[AGENT][POSITIVE] You did not, but I'll happily give you a reference number. It's going to be my name and today's date, and I spell my name [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][POSITIVE] All right, thank you. I appreciate your help.
[AGENT][NEUTRAL] OK
[AGENT][POSITIVE] [PII], it's been a pleasure to assist you with that claim status. Thank you for calling APL and I hope you have a wonderful day.
[CUSTOMER][NEUTRAL] You too. Bye-bye.
[AGENT][POSITIVE] Thank you, [PII]. Bye-bye.
[CUSTOMER][NEUTRAL] Yeah