AccountId: 011433970860
ContactId: 7f502bbc-958a-4d18-b1dc-eaa4afa5c027
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 241940 ms
Total Talk Time (AGENT): 111963 ms
Total Talk Time (CUSTOMER): 96633 ms
Interruptions: 3
Overall Sentiment: AGENT=0.2, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/12/7f502bbc-958a-4d18-b1dc-eaa4afa5c027_20250212T18:18_UTC.wav
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[AGENT][POSITIVE] Good Afternoon, thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, [PII]. This is [PII] from Baptist Outpatient Services. I need to check status on a claim, please.
[AGENT][NEUTRAL] OK, sure. I can assist you with claims, [PII]. May I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Policy number is 01843884ML8.
[AGENT][NEUTRAL] All right. May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] This is on [PII] [PII].
[AGENT][NEUTRAL] OK, and may I have the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] Date of service is [PII] and the amount of $3,739.
[AGENT][NEUTRAL] All right. Let me see if I can find this claim for you. And Ms. [PII], for future, you can check claim status online through our website at [PII], and that's just optional.
[AGENT][NEUTRAL] Um, let me pull this. You're welcome. One moment.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEGATIVE] Yeah, I don't think they ever fixed it. You guys are still requesting. Let me see if they ever a um public.
[CUSTOMER][NEUTRAL] Uh, what is it? A in public?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yeah, they used to be that you guys would request um.
[CUSTOMER][NEUTRAL] Patient's social security number and that we don't.
[CUSTOMER][NEUTRAL] Obtain that information since it's no longer used as a um.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] Mm, yeah, that's an idea, yeah.
[CUSTOMER][NEUTRAL] HIPAA verification, yeah.
[AGENT][NEUTRAL] Yeah, I think it's still asking for it. Let me just go ahead and give you that information, yeah.
[CUSTOMER][NEGATIVE] That's horrible. You would think they fixed it by now, right? Or uh get another, other method of verification.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] Yeah, they were working on it. I'm not sure if they have, but I don't think so. I haven't heard anything recently, so I'm probably not. Um, yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Let me go ahead and give you the information of the claim.
[AGENT][NEUTRAL] It looks like we processed this claim on [PII].
[AGENT][NEUTRAL] And the claim was denied. The reason for this denial is, let's see, benefits are payable only if major medical insurance provides benefits.
[CUSTOMER][NEUTRAL] Hm.
[AGENT][NEUTRAL] Let me check the EB. Let me look at the EOB.
[CUSTOMER][NEUTRAL] Um, we did, let me see.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Oh, yeah.
[AGENT][NEGATIVE] The, the EOB is also zeros.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Oh, is it?
[AGENT][NEUTRAL] Yes, mhm.
[CUSTOMER][NEUTRAL] OK, alright, I see what they did. OK, so is, can I fax COB only or do I have to fax the whole claim?
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] You can uh fax just the AOB mhm.
[CUSTOMER][NEUTRAL] OK. Can I please have a claim number?
[AGENT][NEUTRAL] Yes, the claim number is 3532862.
[CUSTOMER][NEUTRAL] 353-286-2
[AGENT][NEUTRAL] Yes, mhm.
[CUSTOMER][POSITIVE] Perfect. I'll fax it right now.
[AGENT][NEUTRAL] Alright, is there any?
[CUSTOMER][POSITIVE] Thank you so much.
[AGENT][NEUTRAL] You're welcome. Is there anything else I can help you with today, Ms. [PII]?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][POSITIVE] No, ma'am, that would be it. Thank you so much.
[AGENT][POSITIVE] You're welcome and thank you for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] You too bye bye.