AccountId: 011433970860
ContactId: 8915b640-7704-41a7-86c2-38ab275cf221
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 499720 ms
Total Talk Time (AGENT): 128269 ms
Total Talk Time (CUSTOMER): 115778 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/25/8915b640-7704-41a7-86c2-38ab275cf221_20250325T17:33_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. Could you please help me with the claim?
[AGENT][POSITIVE] I'm happy to check on a claim for you today, [PII]. Can I get the patient's policy number?
[CUSTOMER][NEUTRAL] It is 141.
[CUSTOMER][NEUTRAL] 9025.
[AGENT][NEUTRAL] Let me try and pull this up one moment.
[AGENT][NEUTRAL] What's the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Member's name
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Date of birth.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] All right, [PII], can you repeat the policy number to me one more time?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] It is 141.
[CUSTOMER][NEUTRAL] 902
[CUSTOMER][NEUTRAL] 5
[AGENT][NEUTRAL] All right, thank you for that. And then what is the date of service for [PII]?
[CUSTOMER][NEUTRAL] Date of service, [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And the total charge amount, $888.69.
[CUSTOMER][NEUTRAL] And it was actually resubmitted with primary UB on [PII].
[AGENT][NEUTRAL] OK. Do you have an amount uh due after the primary paid different than 88869?
[CUSTOMER][NEUTRAL] Yes, it is $200.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] OK, so we've received this claim a couple of times. We did receive it on 224-25. We're still needing the explanation of benefits. We have not received that from the primary.
[CUSTOMER][NEUTRAL] Uh, but we have attached this in Billings rubber. Do I need, do we need to send?
[CUSTOMER][NEUTRAL] It um it in another way so that we can uh easily process this claim.
[AGENT][NEUTRAL] You can resend it. Would you like to verify the fax number or mailing address or payer ID? I can provide you that information.
[CUSTOMER][NEUTRAL] You can provide me the mailing address.
[AGENT][NEUTRAL] Mailing address is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] In [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And the zip code is [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, thank you. Could you please also help me with the uh two more claims I have.
[AGENT][NEUTRAL] Uh, same patient or different?
[CUSTOMER][NEUTRAL] No, it is for the different one.
[AGENT][NEUTRAL] All right, let me just notate this patient and we can.
[CUSTOMER][NEUTRAL] But same tax ID.
[AGENT][NEUTRAL] What's the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Ma'am's name [PII].
[CUSTOMER][NEUTRAL] Date of birth
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] I need the member's policy number, please.
[CUSTOMER][NEUTRAL] Sure. 022.
[CUSTOMER][NEUTRAL] 030
[CUSTOMER][NEUTRAL] 89
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] OK, and for [PII], what's the data service?
[CUSTOMER][NEUTRAL] Date of service, [PII].
[AGENT][NEUTRAL] And the build out.
[CUSTOMER][NEUTRAL] $760.37.
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] This claim, it looks like was received on [PII].
[AGENT][NEUTRAL] It was denied [PII]. We need the primary EOB.
[CUSTOMER][NEUTRAL] And what's the claim ID?
[AGENT][NEUTRAL] Claim is 352-938-87.
[CUSTOMER][POSITIVE] OK. Thank you.
[CUSTOMER][NEUTRAL] I have the last one.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] What's the member's ID, [PII]?
[CUSTOMER][NEUTRAL] 014
[CUSTOMER][NEUTRAL] 827
[CUSTOMER][NEUTRAL] 96.
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] Member's name
[CUSTOMER][NEUTRAL] ENP
[CUSTOMER][NEUTRAL] Queen one
[CUSTOMER][NEUTRAL] And the date of birth is [PII].
[AGENT][NEUTRAL] OK, and then data service.
[CUSTOMER][NEUTRAL] Date of service is [PII].
[AGENT][NEUTRAL] And they build them out.
[CUSTOMER][NEUTRAL] And the total charge amount.
[CUSTOMER][NEUTRAL] It is $968.98.
[AGENT][NEUTRAL] This claim was received [PII]. It was denied on [PII], requesting the primary EOB.
[CUSTOMER][NEUTRAL] OK. And what is the claim ID for this one?
[AGENT][NEUTRAL] 353.
[AGENT][NEUTRAL] 0351.
[CUSTOMER][POSITIVE] OK. Thank you.
[AGENT][POSITIVE] You're welcome. Anything else I can help with today?
[CUSTOMER][NEUTRAL] No.
[AGENT][POSITIVE] Thank you for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] OK.