AccountId: 011433970860
ContactId: 5d0724e7-1b3c-44d1-947a-28b255188823
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 409549 ms
Total Talk Time (AGENT): 174449 ms
Total Talk Time (CUSTOMER): 140313 ms
Interruptions: 1
Overall Sentiment: AGENT=1.4, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/17/5d0724e7-1b3c-44d1-947a-28b255188823_20250117T17:46_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, good morning. I'm [PII] calling you from provider's office to check on a claim status.
[AGENT][POSITIVE] It would be my pleasure to assist you. Do you mind spelling your name for documentation?
[CUSTOMER][NEUTRAL] Sure. [PII].
[AGENT][POSITIVE] Thank you, [PII]. And what is a good callback number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you. And the policy number for the patient, please.
[CUSTOMER][NEUTRAL] Sure, [PII], before proceeding further, I would like to inform you that this call is getting recorded for quality and training purposes. Member ID is 023.
[CUSTOMER][NEUTRAL] 31253.
[AGENT][NEUTRAL] And what is the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][POSITIVE] Alright thank you [PII], and it would be my pleasure to assist you with that claim status. What is the data service?
[CUSTOMER][NEUTRAL] It's September 4, 2024 with $500 even.
[AGENT][NEUTRAL] All right, thank you. And what is the facility name please, [PII]?
[CUSTOMER][NEUTRAL] Diagnostic Center for Women LLC.
[AGENT][NEUTRAL] All right, thank you. I do see that we received that claim on [PII].
[AGENT][NEUTRAL] Because if the claim is pending for the primary EOB we are secondary to their major medical.
[CUSTOMER][POSITIVE] All right, [PII], thank you so much. Actually, we have submitted a primary UV via fax on [PII]. Can you please check whether you have received it or not?
[AGENT][NEUTRAL] We have not received that EOB. Do you know what number it was sent to?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] That is correct. Can that be resent?
[CUSTOMER][NEUTRAL] Sure, I will resend this again. And can I get the claim number, please?
[AGENT][NEUTRAL] My claim number is 351.
[AGENT][NEUTRAL] 561 5
[CUSTOMER][POSITIVE] Alright [PII], thank you so much for the assistance. Actually I do have two more claims of different patients. Will it be possible for you to assist?
[AGENT][POSITIVE] It would be my pleasure to assist you with those 2 patients. I am ready for that next policy number whenever you are, to.
[CUSTOMER][NEUTRAL] It's 1873596.
[AGENT][NEUTRAL] And [PII], what is that patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] OK. Let me just get that policy pulled up.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And that data service please sir?
[CUSTOMER][NEUTRAL] [PII] with $500 even.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Now bear with me just one moment. This policy actually turned on 3-124.
[AGENT][NEUTRAL] So I'm checking to see if they had active coverage for that data service.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] Bear with me just one moment.
[CUSTOMER][POSITIVE] Sure, take your time, [PII].
[AGENT][NEUTRAL] OK, for that data service I do have a policy that was active. I can give you the correct policy information.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] For data service 58, the the correct policy number is 2496407.
[CUSTOMER][POSITIVE] Alright, thank you so much for that information, [PII]. So do we need to rebuild the claim again on the correct policy ID?
[AGENT][NEUTRAL] Actually, what is the bill amount?
[CUSTOMER][NEUTRAL] Uh, it's $500 even.
[AGENT][NEUTRAL] OK, let me check that.
[AGENT][NEUTRAL] And what is that provider name?
[CUSTOMER][NEUTRAL] Diagnostic Center for Women LLC.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Yes, we received that claim on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Processed on [PII].
[AGENT][NEUTRAL] And this claim is also pending for the primary EOB.
[CUSTOMER][NEUTRAL] Alright, thank you so much, [PII] and as well for this claim as well we have submitted the primary UB via fax on [PII].
[AGENT][NEGATIVE] We did not receive that.
[CUSTOMER][NEUTRAL] OK, let me just resubmit it as well. Thank you so much, [PII]. Can I get the caller, uh, claim number please?
[AGENT][NEUTRAL] Fax number yeah, claim number 347-0460.
[CUSTOMER][POSITIVE] Perfect. Thank you so much. And can I proceed with the last patient ID?
[AGENT][POSITIVE] I am ready.
[CUSTOMER][NEUTRAL] It's going to be 019.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And [PII], what is that patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] Thank you and that date of service?
[CUSTOMER][NEUTRAL] [PII] with $500 even.
[AGENT][NEUTRAL] Same facility, correct?
[CUSTOMER][POSITIVE] Exactly.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And that claim we received on 103-24 and processed on [PII] pending is pending for the same primary EOB.
[CUSTOMER][NEUTRAL] All right. And we have also submitted that you'll be on [PII].
[CUSTOMER][NEGATIVE] Not received yet.
[AGENT][NEGATIVE] Not received.
[AGENT][NEUTRAL] And you sure that that's been fax to [PII].
[CUSTOMER][NEUTRAL] OK, let me just resubmit mhm.
[CUSTOMER][POSITIVE] Exactly.
[AGENT][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] Sure, not a problem, [PII]. Can I get the claim number, please?
[AGENT][NEUTRAL] Claim number 3514418.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Perfect. Thank you so much, [PII], for the assistance and for our call, the call reference number going to be your name and today's date.
[AGENT][NEUTRAL] It will. Would you like for me to spell my name?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Sure, please go ahead.
[AGENT][NEUTRAL] My name is Alicia, A L I C I A. First initial last name, [PII].
[CUSTOMER][POSITIVE] All right, [PII]. Thank you so much for providing assistance to me. You have a wonderful day. Bye bye.
[AGENT][POSITIVE] It's been my pleasure and thank you for calling APL. You have a wonderful day as well.
[CUSTOMER][NEUTRAL] Bye bye.