AccountId: 011433970860
ContactId: 74851ae7-60c7-4e6a-b638-a370622dc648
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 319309 ms
Total Talk Time (AGENT): 101145 ms
Total Talk Time (CUSTOMER): 257309 ms
Interruptions: 12
Overall Sentiment: AGENT=1.5, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/12/74851ae7-60c7-4e6a-b638-a370622dc648_20250312T16:43_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is speaking. May I help you?
[CUSTOMER][NEUTRAL] So it's just um. Alright well I will. Yes, I'm calling about um some claims we submitted two claims um to Aal through the portal and I haven't received anything back yet and when I look it up online it says there's nothing found so I just wanna make sure that it's gotten there even though I have confirmation I'm still.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] You know, not seeing anything, so OK, so I'm looking at my name is [PII], last initials [PII]
[AGENT][NEUTRAL] OK, and your name is?
[CUSTOMER][NEUTRAL] At least get started if you the thing, but to like is 023343-778.
[AGENT][NEUTRAL] OK, and Ms. [PII], what is the policy number, please?
[AGENT][POSITIVE] OK, thank you one moment.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And what's the patient's name, date of birth?
[CUSTOMER][NEUTRAL] OK, so which part?
[CUSTOMER][NEUTRAL] It is [PII] and the date of birth is [PII]. Just the [PII]. Let's pretend I'm going.
[AGENT][NEUTRAL] OK, and what was, oh, I forgot to ask, do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] Yes, it is [PII] and that rings directly to me there's no extension. See to add service so which one you're asking.
[AGENT][NEUTRAL] OK, thank you, ma'am. And what was the date of service and the amount of the charge?
[CUSTOMER][NEUTRAL] Um, [PII] and the charge was $360.
[CUSTOMER][NEUTRAL] Right, well, when I do that and I.
[AGENT][NEUTRAL] OK, and do you have the balance after primary is processed the claim?
[CUSTOMER][NEGATIVE] It's 360. There's no, um, primary doesn't cover anything.
[AGENT][NEUTRAL] OK, give me one moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] But then there's more. There's 3 different 92586 so since you have, you have to select the one with that game too.
[CUSTOMER][NEUTRAL] the second one you see [PII].
[CUSTOMER][NEUTRAL] but the third one is the same way.
[CUSTOMER][NEUTRAL] The 3rd 1 has the same date. That's why I was like, OK, well, we'll give it the 2nd 1 or the 3rd 1.
[AGENT][NEUTRAL] Uh, one moment, and the name of the provider's office?
[CUSTOMER][NEUTRAL] The stepping stones therapy, therapeutic style.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I don't really understand what that means just because I don't do that part of it, so I don't, I don't, I don't get that. But if you just tell me to say so for January I'm gonna do the change with you.
[AGENT][NEUTRAL] OK, it looks like, uh, we received a claim looks like twice. initially processes benefits payable only if primary pays, and a second time as physiology, speech, and occupational therapy are not covered under the plan.
[CUSTOMER][NEUTRAL] 36 and pick.
[CUSTOMER][NEUTRAL] The 2nd
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] I, um, OK, can I'm unable to get that information on the portal is there any way that I can get a um.
[CUSTOMER][NEUTRAL] An EB sent out because 10.
[AGENT][NEUTRAL] I
[AGENT][NEUTRAL] Oh, I give you the claim number. Um, they have it where you can pull it up by the claim number.
[CUSTOMER][NEUTRAL] OK, OK, let's see, I'll try that. Let me clear this real quick.
[CUSTOMER][NEUTRAL] OK, I get the claim number?
[AGENT][NEUTRAL] OK. Yes, ma'am. It's 34, I'm sorry, 354.
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] OK, the first one that's 2024. Yes, alright, hold on, let me go down so it's backwards to my still has it. No, the zero claims found.
[AGENT][NEUTRAL] 4987.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And I need that EIB or the remittance to send to the patient's um tertiary.
[AGENT][NEUTRAL] OK. What is your fax number?
[CUSTOMER][NEUTRAL] It is [PII].
[CUSTOMER][NEUTRAL] [PII] let's see.
[AGENT][NEUTRAL] OK, that's [PII].
[CUSTOMER][NEUTRAL] Yes, and there's actually another one that's kind of old too that should have been through.
[CUSTOMER][NEUTRAL] It's in January.
[AGENT][NEUTRAL] Oh, you have another claim you need to check status for?
[CUSTOMER][NEUTRAL] Yeah, let me make sure I, um, it, it's just, it is, uh, [PII], and it's the same billed amount. It's $360 and the primary doesn't cover it, so it would be the balance would be $360.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] What is that data service?
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII], yes, of [PII]. OK, well, where's [PII]?
[AGENT][NEUTRAL] OK, I show that one processed as um physiology, speech or occupational therapy is not covered, and I will send this over as well. 356-41.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] A
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] Thank you so much. I'll be smart but I.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right, that's it. Thank you so much. I appreciate it. Y'all are wonderful to work with. I'm gonna tell you, I call a lot of insurance places and y'all are just always so easy to work.
[AGENT][NEUTRAL] All right.
[AGENT][POSITIVE] Oh, that's good. Thank you so much.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So I just need to make sure you knew that. I figured cause you know, y'all probably get fussed out a lot so.
[AGENT][POSITIVE] It's nice to hear.
[AGENT][POSITIVE] A lot. I appreciate it. Thank you so much.
[CUSTOMER][POSITIVE] I appreciate it all. Well, I appreciate it. Thank you. All right, you have a good one.
[AGENT][POSITIVE] You too, Ms. [PII]. Thanks for calling APL.
[CUSTOMER][POSITIVE] All right. Thank you. Bye-bye.
[AGENT][NEUTRAL] Bye.
[CUSTOMER][NEUTRAL] And that