AccountId: 011433970860
ContactId: 601a6b9a-1ea8-457a-ad8b-55843c6cfaa6
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 985520 ms
Total Talk Time (AGENT): 269654 ms
Total Talk Time (CUSTOMER): 218132 ms
Interruptions: 5
Overall Sentiment: AGENT=0.5, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/25/601a6b9a-1ea8-457a-ad8b-55843c6cfaa6_20250625T20:15_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] Hello [PII], my name is [PII]. I'm calling because I had a policy with you guys back in [PII], and I was wondering if I can get a copy of, um, any and all explanation of benefits that you may have during that time frame.
[AGENT][NEUTRAL] OK, I'm sorry, [PII], what information were you needing?
[CUSTOMER][NEUTRAL] Um, a copy of any explanation of benefits that you may have.
[AGENT][NEUTRAL] A copy of an explanation of benefits.
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] Yes, ma'am. I can help you with that. And [PII], what is a good call but uh well, first off, what is your last name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you and what is a good callback number for you?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And do you have your policy number?
[CUSTOMER][NEUTRAL] I do.
[CUSTOMER][NEUTRAL] That was sorry.
[CUSTOMER][NEUTRAL] Um, it was, uh, OK, there's 2 on here, but 022.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 236-59
[CUSTOMER][NEUTRAL] ML and it was either 7 for in hospitals or 8 for outpatient.
[AGENT][NEUTRAL] OK, thank you. So give me a moment please to get your information pulled up.
[CUSTOMER][NEUTRAL] Hm
[CUSTOMER][NEUTRAL] Do you think?
[CUSTOMER][NEUTRAL] Yeah, just throw water, um.
[CUSTOMER][NEUTRAL] Yeah, if you just like you can just, yeah, OK I'll get.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] Thank you. Yeah, sweet.
[CUSTOMER][NEUTRAL] Oh, it's multiple, yeah, well I mean that just makes sense, but I don't know.
[AGENT][NEUTRAL] OK, so [PII], I will need to verify several things with you first for security and any information provided as a verification of benefits and not a guarantee of payment. If you would first please verify your date of birth.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And your home mailing address, please?
[CUSTOMER][NEUTRAL] Oh, at the time, oh.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, at the time it was [PII].
[AGENT][NEUTRAL] Thank you. And your phone number on file is the same as the well, it's the same as the one you gave me, so that's the best number for you, correct? OK. And then lastly, your email address?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][POSITIVE] Yes, that is correct.
[AGENT][NEUTRAL] This appears to have been your
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, this appears to be your work email from that time.
[CUSTOMER][NEUTRAL] Oh,
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] OK, thank you. So what is, and that's no longer valid for you, is that correct?
[CUSTOMER][POSITIVE] That's correct.
[AGENT][NEUTRAL] Is that still a valid email address for you, [PII]?
[CUSTOMER][NEUTRAL] No, it's not.
[AGENT][NEUTRAL] OK, so what is your personal email?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, [PII], and what do you, well, first off, do you have the.
[AGENT][NEUTRAL] Claim number that you were needing the explanation of benefits for?
[CUSTOMER][NEUTRAL] Um, I would need anything from [PII].
[CUSTOMER][NEUTRAL] [PII] or [PII]?
[CUSTOMER][NEUTRAL] Through [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, so let me see what we have on file for you.
[AGENT][NEUTRAL] And the year of the dates of service is for [PII], is that correct?
[CUSTOMER][POSITIVE] That's correct, yeah.
[AGENT][NEUTRAL] So now I can email these to you if you would like.
[CUSTOMER][POSITIVE] That would be great, please.
[AGENT][NEUTRAL] OK, so it's gonna take me a few minutes to do each one to send to you, so bear with me, OK?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Cause I'm gonna have to look at each claim to verify the dates of service.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So it's basically anything in [PII]. Is that what you're needing?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yeah, it's just gonna take a few minutes to do this.
[CUSTOMER][NEUTRAL] OK, I'm so sorry, but.
[AGENT][NEUTRAL] I have they're loading.
[AGENT][NEUTRAL] That's OK. I just don't want you to think that.
[CUSTOMER][NEUTRAL] Got it.
[AGENT][NEGATIVE] I'm not working on it because I am, it's just a kind of a slow process.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] Got you.
[CUSTOMER][NEUTRAL] Itayoma.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] OK, so I think that that is all of them because there were a couple of, there was another data to service, but that was in August, but you said you're just needing anything in October. Is that correct?
[CUSTOMER][NEUTRAL] That's correct. So August state of service, can you tell me um who the billing provider is?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] This is for a [PII] MD.
[CUSTOMER][NEUTRAL] Actually, no, it doesn't matter.
[CUSTOMER][NEUTRAL] Yeah, OK, yeah, so it doesn't matter, yeah, no, no worries.
[AGENT][POSITIVE] No, no worries, you don't need that one, OK. And let me just double check this last one.
[CUSTOMER][NEUTRAL] No, yes.
[AGENT][NEUTRAL] Uh, there is one more. OK. Um.
[AGENT][NEUTRAL] Give me just a second to look at one thing.
[AGENT][NEUTRAL] OK, so the email that you're gonna receive from me, Ms. [PII] is going to come from [PII].
[AGENT][NEUTRAL] And I am putting in the subject line APL EOBs from, I am gonna add [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, that's it.
[AGENT][NEUTRAL] Now, it may take just a minute for that to come through.
[AGENT][NEUTRAL] But if you're able to possibly check your email while we're still on our call just to verify that you did receive them.
[CUSTOMER][NEUTRAL] OK, I am on my email now, so.
[AGENT][NEUTRAL] OK. It may take a second to come through since it had several attachments on it.
[CUSTOMER][NEUTRAL] Well, definitely.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] From what you're able to see, can you tell me how many explanations, uh, how many EOBs you see?
[AGENT][NEUTRAL] Um, I believe you're going, yeah. Mhm.
[CUSTOMER][POSITIVE] Oh, I got it actually.
[AGENT][NEUTRAL] So there should be 4 attached. Mhm.
[CUSTOMER][NEUTRAL] Yeah, see.
[CUSTOMER][NEUTRAL] 23 from doctor.
[CUSTOMER][NEUTRAL] 1013 from.
[CUSTOMER][NEUTRAL] It's not probably gonna happen. Yeah, I had my.
[CUSTOMER][NEUTRAL] Yeah, our patient is like from the 5th.
[CUSTOMER][POSITIVE] Perfect.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] This is exactly what I need.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK, I appreciate your help. Thank you so much.
[AGENT][POSITIVE] Oh, you are certainly very welcome. Is there anything else that I could help you with today?
[CUSTOMER][NEUTRAL] Um, you know what, actually, yes. Can you clarify to me how
[CUSTOMER][NEUTRAL] Oh, so, OK, can you just refresh my memory? I would, was this the one where I would have to bill you guys and you guys paid me directly, or was, were they billing you guys and then you paid them directly?
[AGENT][NEUTRAL] On some of either, it depends on some of these explanation of benefits, um, it looks like you filed.
[AGENT][NEUTRAL] One of the claims or 2 of the claims and the providers have filed claims, 2 of them.
[AGENT][NEUTRAL] So the claim number ending in 84, the benefit was paid to you.
[CUSTOMER][NEUTRAL] 84 the claim was paid to me.
[AGENT][NEUTRAL] That benefit was paid to you. Yes, ma'am, it looks like that you, you filed that and on
[CUSTOMER][NEUTRAL] Every
[CUSTOMER][NEUTRAL] And then
[CUSTOMER][NEUTRAL] And then everything else.
[AGENT][NEUTRAL] Right, and the claim number ending in 7800 were paid to the providers.
[AGENT][NEUTRAL] And then there was one, the one ends in 65, that claim was denied.
[CUSTOMER][NEUTRAL] OK, so that was denied.
[AGENT][NEUTRAL] Mhm. And it looks like you did file that one.
[CUSTOMER][NEUTRAL] 84 with.
[CUSTOMER][NEUTRAL] OK, can you clarify the one ending in 59?
[AGENT][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Uh, I'm sorry, 78.
[AGENT][NEUTRAL] That one was paid to the provider.
[CUSTOMER][POSITIVE] Same number 78 was paid directly to the providers. Thank you, thank you so much.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][POSITIVE] Uh-huh. Yes, ma'am. Oh, you're welcome. So is there anything else I can help you? Uh-huh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And then it
[CUSTOMER][NEUTRAL] Um, yes, a reference number, please.
[AGENT][NEUTRAL] You would use my name that I gave you along with today's date.
[CUSTOMER][NEUTRAL] OK, refresh my memory on your name.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] And then 6 25 25. Thank you so much, [PII].
[AGENT][POSITIVE] Yes, ma'am. Well, you're very welcome. So if that is all I can help you with today, thank you again for calling APL and I hope you have a nice rest of your day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Yes, ma'am. Thank you. Bye-bye.