AccountId: 011433970860
ContactId: 6f64b710-fbc6-4856-a2bb-2e9c8b62acd6
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 497559 ms
Total Talk Time (AGENT): 120648 ms
Total Talk Time (CUSTOMER): 132987 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/18/6f64b710-fbc6-4856-a2bb-2e9c8b62acd6_20250318T19:09_UTC.wav
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[AGENT][NEUTRAL] How may I assist you?
[CUSTOMER][NEUTRAL] Hello? Hello? Can you hear me?
[AGENT][NEUTRAL] Yes, I can hear you.
[CUSTOMER][NEUTRAL] Hi, hello. Good morning, uh, uh, good afternoon. This is, uh, [PII] calling for office. May you allow me to verify your claiming status?
[AGENT][NEUTRAL] May I have a callback number?
[CUSTOMER][NEUTRAL] [PII]. No extension.
[AGENT][NEUTRAL] And may I have the policy number?
[CUSTOMER][NEUTRAL] Um, 01678621.
[CUSTOMER][NEUTRAL] [PII] 8.
[AGENT][NEUTRAL] May I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Uh, this is [PII], uh, I'm sorry, it's [PII], and date of birth is uh [PII].
[AGENT][NEUTRAL] And you're calling in for status of claim.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] May I have the date of service and total bill?
[CUSTOMER][NEUTRAL] Of course. Uh, the date of service is, uh, October, uh, let me see, [PII].
[CUSTOMER][NEUTRAL] And the billet amount is um $395 even um a secondary payer.
[AGENT][NEUTRAL] I'm pulling that information up for you now.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And that is for data service of 10523 total be a charge 395.
[AGENT][NEUTRAL] I have pulled that information up for you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It does show that we received when we processed that claim on [PII].
[AGENT][NEUTRAL] The claim number is 348.
[CUSTOMER][NEUTRAL] That
[AGENT][NEUTRAL] 3854. It shows that the claim processed and that it denied.
[CUSTOMER][NEUTRAL] Pardon?
[AGENT][NEUTRAL] I guess the claim was processed.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] On HA, let me look at the, let me look at the image first.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Because I believe it was only a statement bill or something that was submitted in we didn't receive a claims form.
[CUSTOMER][NEUTRAL] Yes, uh, we submitted along with the, it'll be from the primary.
[AGENT][NEUTRAL] So yes, you submitted the EOB but with this coming in from the provider, we have to have a HI for 1500 claim form.
[AGENT][NEUTRAL] That's what it was requesting. Let me see.
[AGENT][NEUTRAL] Because I'm not seeing.
[AGENT][NEUTRAL] A hit for 1500 for the date of service of [PII].
[CUSTOMER][NEUTRAL] And um well, how do you receive this claim?
[CUSTOMER][NEUTRAL] If you don't have the XA 1500.
[AGENT][NEUTRAL] We only have an EOB, an image of an EOB.
[CUSTOMER][NEUTRAL] Oh, let me see, let me see. Just give me one second.
[CUSTOMER][NEUTRAL] H N
[CUSTOMER][NEUTRAL] You receive this um claim by.
[CUSTOMER][NEUTRAL] Um, by fax or uh by mail?
[AGENT][NEUTRAL] It had to be submitted via mail.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] And uh do you know if you are out of the time of the filing to send a correct the claim or send the uh uh HA 1500?
[AGENT][NEGATIVE] We don't have any timely filing.
[CUSTOMER][NEUTRAL] So uh.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEGATIVE] We shall send this uh claims again.
[CUSTOMER][NEUTRAL] Only the, the HAA or we need to send the HA along with the UB from the prime.
[AGENT][NEUTRAL] it would be best to send both the documentations at the same time.
[CUSTOMER][NEUTRAL] Uh, but if there's no issues with the duplicated claim.
[AGENT][NEUTRAL] Are you saying there's no issue?
[AGENT][NEUTRAL] With what kind of car?
[CUSTOMER][NEUTRAL] Oh yes, with this one that you have on file?
[AGENT][NEUTRAL] No, it's not an issue, but it's still best to send both documentations at the same time.
[CUSTOMER][NEUTRAL] Oh, OK. OK, we will send this, uh, uh, documentation to, um, again. Uh, may you help me with the claim mailing address?
[AGENT][NEUTRAL] Yes, would you like to submit it via fax?
[CUSTOMER][POSITIVE] Um, yes, it's better.
[AGENT][NEUTRAL] OK. Are you ready for the fax number?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] The fax number is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And that is attention claims department.
[CUSTOMER][NEUTRAL] Got it.
[CUSTOMER][NEUTRAL] Um, it is [PII].
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] OK. Thanks for your help. Uh, can you help me with your name and account reference number again, please?
[AGENT][NEUTRAL] Yes, the call reference would be my first name [PII], last initial of [PII] and today's date.
[CUSTOMER][POSITIVE] Got it. Thanks for your help. Really appreciate it.
[AGENT][POSITIVE] You're welcome. You're so welcome. Thank you for calling American Public Life Lester. Have a great day.
[CUSTOMER][POSITIVE] You as well take care bye bye.
[AGENT][POSITIVE] Thank you. Bye-bye.