AccountId: 011433970860
ContactId: 86cdde82-e6be-4da5-93f3-0641f09be4a9
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 143000 ms
Total Talk Time (AGENT): 61670 ms
Total Talk Time (CUSTOMER): 81240 ms
Interruptions: 2
Overall Sentiment: AGENT=1.2, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/28/86cdde82-e6be-4da5-93f3-0641f09be4a9_20250128T21:21_UTC.wav
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[AGENT][NEUTRAL] Hi, thank you for calling ACL. This is [PII]. How can I help you today?
[CUSTOMER][NEUTRAL] Hi, good afternoon, [PII]. Uh, my name is [PII], uh, group number 16944.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] And how can I help you today, sir?
[CUSTOMER][NEUTRAL] I'm [PII], uh, I'm
[CUSTOMER][NEUTRAL] I'm at a doctor's office, uh, with my wife. I just paid $10 co-payment.
[CUSTOMER][NEUTRAL] And uh with my regular Aetna uh insurance, but they say that they don't take the APL that I have to make uh.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, a claim to you guys so you could cover the co-payment of $10.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Is that how it works?
[AGENT][NEUTRAL] Unfortunately some providers will not submit claims um for secondary and that they're they're allowed to not do that um it's always a bummer but you absolutely can submit a claim to us.
[AGENT][NEUTRAL] Um, are you still at the facility?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Um, you might ask them if they can give you or if they can help you get, um, but there's a name of a document you're gonna want from them, and it's a CMS 1500.
[CUSTOMER][NEUTRAL] Oh, OK, hold on, hold on.
[AGENT][POSITIVE] Oh, I'm sorry.
[CUSTOMER][NEUTRAL] Oh yeah.
[CUSTOMER][POSITIVE] This is a boy I'm my undoo because I'm a CMS.
[CUSTOMER][NEUTRAL] See ques.
[CUSTOMER][NEUTRAL] A billing, OK, no [PII]. OK, any talk what the legacy at CMS quevilimo uh cuandolial after billing.
[CUSTOMER][NEUTRAL] And they say that they will give me a document after uh they bill for this.
[CUSTOMER][NEUTRAL] Uh, not now. Because the patient is not fit yet. Right. It's not there.
[AGENT][NEUTRAL] Not now.
[AGENT][NEUTRAL] So you might have to wait for them to go through their process um but basically what you're gonna want is that that document that they have and you would just submit that along with an explanation of benefits from your primary insurance to us and then we'd be able to process everything from there.
[CUSTOMER][NEUTRAL] And.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] All right, all right, thank you.
[AGENT][POSITIVE] Yeah, it's my pleasure, glad I could help.
[CUSTOMER][NEUTRAL] All right bye bye.
[AGENT][NEUTRAL] Bye bye.