AccountId: 011433970860
ContactId: 69c787ba-b9e2-4820-baab-f9e82c40ee3a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 273359 ms
Total Talk Time (AGENT): 99087 ms
Total Talk Time (CUSTOMER): 111144 ms
Interruptions: 1
Overall Sentiment: AGENT=0, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/09/69c787ba-b9e2-4820-baab-f9e82c40ee3a_20250509T16:11_UTC.wav
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[AGENT][NEUTRAL] And thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Uh yes ma'am. I am calling from a provider's office.
[CUSTOMER][NEUTRAL] Um, I'm trying to.
[CUSTOMER][NEUTRAL] I guess the short story, figure out if a patient's insurance was active at the time of a claim, um.
[AGENT][NEUTRAL] OK, may I ask who's calling?
[CUSTOMER][NEUTRAL] Hey, hey, my name's [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] And do you have a phone number I could get, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And do you have their policy number?
[CUSTOMER][NEUTRAL] I think I do. We, we, we have nothing. We just have 02541659.
[AGENT][NEUTRAL] Thank you, [PII]. Hold on one moment, please.
[CUSTOMER][NEUTRAL] Alright.
[AGENT][NEUTRAL] And what's the patient's name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And his date of birth?
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][NEUTRAL] Thank you, [PII]. And you were wanting to know if his policy was active on a certain date?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, I can help you with that. What date were you inquiring about?
[CUSTOMER][NEUTRAL] I am looking for [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yes, ma'am. It was active at that time.
[CUSTOMER][NEUTRAL] OK, um, can you give me a claims address? We don't have anything.
[AGENT][NEUTRAL] OK, it is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Alright.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Alright.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Alright and let me.
[CUSTOMER][NEUTRAL] Um, do you have a payer ID?
[AGENT][NEUTRAL] 60801.
[AGENT][NEUTRAL] We have a claims for that data service.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] I do.
[AGENT][NEUTRAL] What, what's the, um, what did he have done?
[CUSTOMER][NEUTRAL] Uh.
[AGENT][NEUTRAL] What's the procedure?
[CUSTOMER][NEUTRAL] Um, but he had, I believe it was on just an office visit 99214 and an EKG 93,000.
[AGENT][NEUTRAL] The
[AGENT][NEGATIVE] Yeah, OK, yeah, we have that claim. We are, we are needing the offices it's not covered at all. It was denied and then for the 93,000 we need the explanation of benefits from the primary.
[CUSTOMER][NEUTRAL] OK, so his primary that day he presented us United Healthcare stated that's all he had, and now when we send it to them they're wanting the other payer so he would be.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Uh
[CUSTOMER][NEGATIVE] So he has messed himself up.
[AGENT][NEUTRAL] Yes, because see, we would have to have their E because we're secondary.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, alright, I'll have to call him and see if he can remember what he had going on.
[AGENT][NEUTRAL] He'll have to call them and tell them him our policy and that we are secondary, so he'll have to get that straightened out.
[CUSTOMER][NEUTRAL] Um, do you have his full, um, coverage dates like when it started and when it stopped?
[AGENT][NEUTRAL] I do, um.
[AGENT][NEUTRAL] This policy was effective [PII].
[CUSTOMER][POSITIVE] Oh, so he, he's been seen multiple times this year and hasn't said anything. OK, perfect.
[CUSTOMER][NEUTRAL] Alright, well, is there a reference number for our call?
[AGENT][NEUTRAL] We do not have reference numbers. You can use my name and today's date. Is there anything else I can help you with?
[CUSTOMER][POSITIVE] That's everything. Thank you so much.
[AGENT][POSITIVE] Thank you, [PII] for calling APL. You have a good day.
[CUSTOMER][POSITIVE] You too. Thanks.