AccountId: 011433970860
ContactId: 6f68bf67-1bd9-47c2-b901-5547d9fb090e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 698760 ms
Total Talk Time (AGENT): 129405 ms
Total Talk Time (CUSTOMER): 158022 ms
Interruptions: 0
Overall Sentiment: AGENT=0.1, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/14/6f68bf67-1bd9-47c2-b901-5547d9fb090e_20250514T14:50_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. This is [PII] speaking from the provider's office. And before we get started, I just wanted to inform that this call is being recorded for quality and training purposes. Can we continue?
[AGENT][NEUTRAL] Yes, that's fine.
[AGENT][POSITIVE] How can I help today, [PII]?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I'm calling regarding a claim status.
[AGENT][NEUTRAL] OK. Happy to check a claim. What's the policy number, please?
[CUSTOMER][NEUTRAL] 02508098 M as in Mike, L as in Lima, 8.
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Date of birth?
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][NEUTRAL] And data service.
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] And the build out.
[CUSTOMER][NEUTRAL] It's $565 even.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Thank you for your patience on that. So we did receive a claim for this state of service. Claim was received [PII]. Claim was denied on [PII]. Office visits are not covered under the member policy.
[CUSTOMER][NEUTRAL] Can I have the name of the uh
[CUSTOMER][NEUTRAL] Uh, patient's plan.
[AGENT][NEUTRAL] We are the members secondary insurance. This is called a Medlink plan.
[CUSTOMER][NEUTRAL] OK. Can I get a call reference for this one and the claim number as well?
[AGENT][NEUTRAL] Claim number is 3592529. Call reference is my name with my last initial and today's date. My name again is [PII], that's [PII] Last initial is [PII].
[CUSTOMER][NEUTRAL] OK. Just a second, I'll complete my documentation.
[CUSTOMER][NEUTRAL] Can we move on to the next question?
[AGENT][NEUTRAL] And what's the next policy number?
[CUSTOMER][NEUTRAL] It is 02221656. M as in Mike, L as in Lima, 8.
[AGENT][NEUTRAL] Patient name and date of birth.
[CUSTOMER][NEUTRAL] Patient's name is [PII] and date of birth is [PII].
[AGENT][NEUTRAL] Data service.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And the bill amount is $619 even.
[AGENT][NEUTRAL] All right. One moment, please.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Do you have a different amount after the primary paid?
[CUSTOMER][NEUTRAL] Yeah, the balance amount is $113.17.
[AGENT][NEUTRAL] 113 17.
[CUSTOMER][NEUTRAL] 13,870.
[AGENT][NEUTRAL] Are you sure on that amount? Because we got a claim for the $619 and it was denied requesting the explanation of benefits.
[AGENT][NEUTRAL] But I don't see anything for 113 17.
[CUSTOMER][NEUTRAL] I told you 6 $19 even you then said that another.
[CUSTOMER][NEUTRAL] Thing is
[CUSTOMER][NEUTRAL] I previously said 6:19 only before.
[CUSTOMER][NEUTRAL] OK, it's denied for primary UB.
[AGENT][POSITIVE] Yes, that is correct.
[CUSTOMER][NEUTRAL] OK, just a second. I'll check if you have sent it or not.
[CUSTOMER][NEUTRAL] So we have sent it via fax, via on fax number [PII] on [PII].
[AGENT][NEUTRAL] Alright, one moment, please.
[AGENT][NEUTRAL] I don't show that we have anything on file.
[CUSTOMER][NEUTRAL] So, can I get the
[CUSTOMER][NEUTRAL] Fax number.
[AGENT][NEUTRAL] The fax number is [PII].
[CUSTOMER][NEUTRAL] But I can see we have sent it. So why you have not received it, we have sent it by the same fact.
[AGENT][NEGATIVE] It just don't show anything on our side. I apologize, it needs to be resubmitted.
[CUSTOMER][NEUTRAL] OK, just a second.
[CUSTOMER][NEUTRAL] Just a second, I'll complete my documentation.
[CUSTOMER][NEUTRAL] Can I get a call reference number?
[AGENT][NEUTRAL] That is my name with today's date.
[CUSTOMER][NEUTRAL] OK, same for. Can I get the claim number?
[AGENT][NEUTRAL] 352-979-5
[CUSTOMER][NEUTRAL] OK, we'll submit it again. I hope we are within the t.
[AGENT][NEUTRAL] OK. Is there anything else I can help with?
[CUSTOMER][NEUTRAL] Yeah, another patient, another claim.
[AGENT][NEUTRAL] What's the policy number?
[CUSTOMER][NEUTRAL] Yeah. How many patients you can assist at a time?
[AGENT][NEUTRAL] As many as you have.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I currently have 4.
[AGENT][NEUTRAL] Proceed when you're ready.
[CUSTOMER][NEUTRAL] Yeah, just a second.
[CUSTOMER][NEUTRAL] Yeah, the next member ID would be 02557885.
[AGENT][NEUTRAL] Name and date of birth?
[CUSTOMER][NEUTRAL] Name is [PII] and date of birth is
[CUSTOMER][NEUTRAL] February [PII], [PII].
[AGENT][NEUTRAL] Data service.
[CUSTOMER][NEUTRAL] [PII] and the amount is $758.
[CUSTOMER][NEUTRAL] Um
[AGENT][NEUTRAL] Claims received [PII], denied [PII], requesting the primary insurance EOB.
[CUSTOMER][NEUTRAL] Can I get the claim number?
[AGENT][NEUTRAL] 357-712-7
[CUSTOMER][POSITIVE] Thank you so much, [PII]. You have been a great help to me. I hope you have a nice day.
[AGENT][NEUTRAL] You as well.