AccountId: 011433970860
ContactId: 6541076f-88ca-4f78-afce-8c1302341e40
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 228839 ms
Total Talk Time (AGENT): 78546 ms
Total Talk Time (CUSTOMER): 81586 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/06/6541076f-88ca-4f78-afce-8c1302341e40_20250306T21:40_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 there. My name is [PII] calling from the office and I'm checking on the claim status.
[AGENT][POSITIVE] OK, well, I'll be more than happy to help you with the claim status. And [PII], may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yeah, it's [PII].
[AGENT][NEUTRAL] Thank you for that. And the member's policy number?
[CUSTOMER][NEUTRAL] Policy number is 023.
[CUSTOMER][NEUTRAL] 007.
[CUSTOMER][NEUTRAL] 09 M as in Mary, L as in Lima 7.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Yeah, patient is [PII]. Date of birth is.
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And may I have the date of service for the claim?
[CUSTOMER][NEUTRAL] Yeah, date of services from.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the total bills amount?
[CUSTOMER][NEUTRAL] $2100 even.
[AGENT][NEUTRAL] All right, here we go hold on one moment.
[AGENT][NEUTRAL] And can you verify the name of the provider's office on the claim?
[CUSTOMER][NEUTRAL] Yeah, it's Naples Community Hospital.
[AGENT][NEUTRAL] 34, hold on one moment.
[AGENT][NEUTRAL] Alright, so I'm trying to received the claim on [PII].
[AGENT][NEUTRAL] Claim number is 3496625.
[CUSTOMER][NEUTRAL] Uh-huh. Actually, yeah, um, I have the status of that claim. Uh, I believe that was not for primary UB. So, um, we, we rebuild the claim, uh, along with that primary UB on [PII]. So can you please check whether the document was received or not?
[AGENT][NEUTRAL] And
[AGENT][NEGATIVE] Yes, it was received and it was denied as a duplicate. It was received on [PII]. Claim number is 356.
[AGENT][NEUTRAL] 887 8.
[AGENT][NEUTRAL] So we still have not received the explanation of benefits from primary insurance.
[CUSTOMER][NEUTRAL] OK. And this was denied on [PII], right?
[AGENT][NEUTRAL] Hold on one moment.
[AGENT][NEGATIVE] No, it was received on the [PII]. It was denied on [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And I just want to verify is, is APL is APL a Medicare supplement policy?
[AGENT][NEUTRAL] No, we're not affiliated with Medicare or Medicaid.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And may I have the reference number for this call?
[AGENT][NEUTRAL] Sure, so there's no call reference number, but you can use my name in today's date. The first initial to my last name is [PII].
[CUSTOMER][POSITIVE] OK. So, thanks so much, [PII], and have a wonderful day. Bye.
[AGENT][POSITIVE] You're very welcome. Thanks for calling APL. Bye bye.