AccountId: 011433970860
ContactId: 627f8acc-385f-4fe7-8e28-7995e5f0ba8e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 553309 ms
Total Talk Time (AGENT): 192463 ms
Total Talk Time (CUSTOMER): 111708 ms
Interruptions: 1
Overall Sentiment: AGENT=1, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/28/627f8acc-385f-4fe7-8e28-7995e5f0ba8e_20250228T17:39_UTC.wav
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[AGENT][POSITIVE] Good afternoon thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. This is [PII] and I'm trying on a claim status.
[AGENT][POSITIVE] [PII] would be my pleasure to assist you with claim status. What is the callback number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, [PII]. And what is the policy number for the patient?
[CUSTOMER][NEUTRAL] 02377560
[AGENT][NEUTRAL] And the patient's name and date of birth, please, sir?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][POSITIVE] Thank you and it would be my pleasure to assist you with that claim status. What is the date of service?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And what is the bill amount?
[CUSTOMER][NEUTRAL] $6,498.50.
[AGENT][NEUTRAL] Thank you, [PII]. What about the facility name?
[CUSTOMER][NEUTRAL] Baka Valley Hospital.
[AGENT][NEUTRAL] Alright, thank you. I can help you with that claim status. We received that claim on [PII].
[AGENT][NEUTRAL] Claim was processed on [PII].
[AGENT][NEUTRAL] And the claim was denied as services were rendered after the policy turned.
[CUSTOMER][NEUTRAL] So what was the term date?
[AGENT][NEUTRAL] Term date is [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Do you show any other active insurance?
[AGENT][NEUTRAL] Not with APL.
[CUSTOMER][NEUTRAL] All I have policy? OK. What's the claim number?
[AGENT][NEUTRAL] Claim number is 356.
[AGENT][NEUTRAL] 1450.
[CUSTOMER][NEUTRAL] 450.
[CUSTOMER][NEUTRAL] OK, hold on.
[CUSTOMER][NEUTRAL] And uh can you send us a copy of EB via fax?
[AGENT][NEUTRAL] EOBs are obtainable from our provider portal at [PII]. It is a simple self-registration.
[AGENT][NEUTRAL] Using the tax ID number and the patient's account number listed in box 3A on the UBO4.
[AGENT][POSITIVE] I can assist you with that account if you need assistance.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Oh, what's
[CUSTOMER][NEUTRAL] Can you repeat the um what's the uh the website again?
[AGENT][NEUTRAL] Sure, it's [PII].
[CUSTOMER][NEUTRAL] OK, hold on.
[AGENT][POSITIVE] And once you're there, I'll be happy to give you the information needed.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] It says American fidelity systems are currently offline.
[AGENT][NEGATIVE] Oh no.
[AGENT][NEUTRAL] OK, just bear with me just one second.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I am so sorry. So, for future reference, when you go to that, you wanna try it one more time cause it looks like I'm not getting that.
[AGENT][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] OK, hold on.
[CUSTOMER][POSITIVE] Oh yeah, it's working now.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So, new user, right?
[AGENT][NEUTRAL] That's correct. And you're gonna choose the last option. You're, you are a medical or dental provider.
[AGENT][NEUTRAL] And then it's gonna ask you for your
[CUSTOMER][NEUTRAL] Where they go.
[AGENT][NEUTRAL] Yeah, it's gonna be the last one. I'm just gonna ask you for your tax ID when it gets to the patient account number, if you'll let me know, I can give you that.
[CUSTOMER][NEUTRAL] OK. Tax ID.
[CUSTOMER][NEUTRAL] OK, hold on.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] What's the patient account number?
[AGENT][NEUTRAL] Patient account number is 016.
[AGENT][NEUTRAL] 377.
[AGENT][NEUTRAL] 651.
[AGENT][NEUTRAL] 01.
[CUSTOMER][NEUTRAL] OK, hold on.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And then I step 3.
[AGENT][NEUTRAL] I apologize.
[AGENT][NEUTRAL] What was that?
[CUSTOMER][NEUTRAL] I'm on step 3 now to create new uh creating account.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, it's been created. I'm just gonna try to log in.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And then I'm on the home screen, start here.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So do you see where it says uh claim status and it's um quick access?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] When you have the claim number, you would use the quick access so you're gonna put the patient's first name and date of birth.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then the claim number.
[CUSTOMER][NEUTRAL] Hold on.
[CUSTOMER][NEUTRAL] So, in order for me to find a claim, I just, uh, I need a claim number.
[AGENT][NEUTRAL] Mhm. So if you don't have a claim number, you would use option 2.
[CUSTOMER][NEUTRAL] So,
[AGENT][NEUTRAL] For claim status.
[CUSTOMER][NEUTRAL] Uh, OK. OK, OK.
[AGENT][NEUTRAL] And then if you have a claim that you need to submit online, you can uh where it says need to file a claim, you can file a claim online as well.
[CUSTOMER][NEUTRAL] OK, I can see it now.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, it's generating the EUB now.
[AGENT][NEUTRAL] That's a lot quicker than waiting for a fax, isn't it?
[CUSTOMER][NEUTRAL] Uh, sorry.
[AGENT][NEUTRAL] I said that's quicker than waiting for a fax, isn't it?
[CUSTOMER][POSITIVE] Yeah, yeah, that's right.
[CUSTOMER][POSITIVE] Mhm. It's a great help.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK. It's downloading now.
[CUSTOMER][NEUTRAL] Let me just
[CUSTOMER][NEUTRAL] Um, I see it first.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] OK, this is good. Uh, do you have a reference number?
[AGENT][NEUTRAL] Yeah, reference number is my name and today's date, and I spell my name [PII]
[AGENT][NEUTRAL] First initial last name, [PII].
[AGENT][POSITIVE] And [PII], it was a pleasure to assist you with that claim status today. Is there anything else I can help you with?
[CUSTOMER][POSITIVE] That'll be all. Thank you so much.
[AGENT][POSITIVE] Thank you, [PII], for calling APL. Hope you have a wonderful weekend.
[CUSTOMER][POSITIVE] All right. Thanks. You too, bye.
[AGENT][POSITIVE] Thank you bye bye.