AccountId: 011433970860
ContactId: 87f7a48e-bd3c-478f-b63a-141528ac1126
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 425790 ms
Total Talk Time (AGENT): 116941 ms
Total Talk Time (CUSTOMER): 154210 ms
Interruptions: 0
Overall Sentiment: AGENT=1.7, CUSTOMER=1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2024/12/31/87f7a48e-bd3c-478f-b63a-141528ac1126_20241231T18:57_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]. I would like to check claim status.
[AGENT][POSITIVE] OK, I'm happy to check on a claim for you today. Do you have the patient's policy number?
[CUSTOMER][NEUTRAL] Yes, I have the policy numbers. Uh, one moment, let me check.
[CUSTOMER][NEUTRAL] I have here ID number 024788777.
[AGENT][POSITIVE] Thank you for that. And if I could get your first name and a callback number?
[CUSTOMER][NEUTRAL] [PII], callback number is [PII] direct line.
[AGENT][NEUTRAL] Thank you for that, [PII]. May I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] Thank you for that. And what is the date of service?
[CUSTOMER][NEUTRAL] But, um, the date of service is, let me check here.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK. And do we have a belt out?
[CUSTOMER][NEUTRAL] The amount is $11,506.
[AGENT][NEUTRAL] And you said $11,506?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Alright, one moment.
[AGENT][NEUTRAL] OK, so it looks like we did receive this claim. We need the explanation of benefits from the primary insurance to complete the claim.
[CUSTOMER][NEUTRAL] OK. May I have the claim received and the process date?
[AGENT][NEUTRAL] Claim is received [PII].
[AGENT][NEUTRAL] Processed [PII].
[CUSTOMER][NEUTRAL] OK, thank you. And how can we submit the primary AOB? Do you have a fax number where we can submit it?
[AGENT][POSITIVE] Mhm. I'm happy to give you that fax number. Let me know when you're ready.
[CUSTOMER][POSITIVE] Yes, I'm ready.
[AGENT][NEUTRAL] Fax number would be [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII] 3.
[CUSTOMER][NEUTRAL] [PII]. OK, thank you. Do we need to attach um primary um the UBO4 with the primary EOB or just the uh primary EOB alone with the side?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah, the only thing additional needed is just the primary explanation of benefits.
[CUSTOMER][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] And just to clarify, the claim number that we have on file is 349-905. Is that correct? For the, for the claim?
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Yes, that is correct.
[CUSTOMER][POSITIVE] OK. Thank you.
[CUSTOMER][NEUTRAL] And may I have a call reference number for this number and if you could help me with one more patient.
[AGENT][NEUTRAL] Call reference is my name with my last initial in today's date. My name again is [PII], that's spelled [PII] Last initial to my name is [PII].
[CUSTOMER][POSITIVE] OK. Thank you so much, [PII].
[AGENT][NEUTRAL] Mhm. And what's the next policy number?
[CUSTOMER][NEUTRAL] OK, um,
[CUSTOMER][NEUTRAL] Uh, let me just pull it up here.
[CUSTOMER][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] The next member ID number is
[CUSTOMER][NEUTRAL] 01877139 M for Mary, L for Lima, 8.
[AGENT][NEUTRAL] Thank you. And may I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Patient's name is [PII], [PII].
[AGENT][NEUTRAL] All right, thank you for that. And what is the date of service?
[CUSTOMER][NEUTRAL] [PII] with the billed amount of $334,468.75.
[AGENT][NEUTRAL] Right, so this claim was also received. It looks like it's requesting the explanation of benefits from the primary insurance also claim was received on [PII].
[AGENT][NEUTRAL] And claim was processed on [PII]?
[CUSTOMER][NEUTRAL] OK. So, we will submit the primary EOD only to the same fax number of [PII], right?
[AGENT][POSITIVE] Mhm. Correct, yes.
[CUSTOMER][NEUTRAL] And the claim number for this one is 349-08007. Is that correct?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][POSITIVE] OK. Um, the same reference number, your name and today's date. I think that would be all, [PII]. Thank you so much for your help.
[AGENT][POSITIVE] You're welcome, [PII]. Have a good day.
[CUSTOMER][POSITIVE] Have a great day. Bye-bye.
[AGENT][NEUTRAL] Bye bye.