AccountId: 011433970860
ContactId: 893797ef-9759-4fa9-b7a7-e0f05d9181d6
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 370339 ms
Total Talk Time (AGENT): 150208 ms
Total Talk Time (CUSTOMER): 128123 ms
Interruptions: 0
Overall Sentiment: AGENT=1.6, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/25/893797ef-9759-4fa9-b7a7-e0f05d9181d6_20250225T20:10_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hey, good afternoon, [PII]. My name is [PII]. I'm calling from Pay on Health Services. I have a claim I need to get a claim status on, please.
[AGENT][POSITIVE] Well, it would be my pleasure to assist you with claim status, [PII]. What is the callback number?
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Yes ma'am, [PII].
[AGENT][NEUTRAL] Thank you [PII], and what is the policy number for the patient?
[CUSTOMER][NEUTRAL] Welcome.
[CUSTOMER][NEUTRAL] 214-822-227
[AGENT][NEUTRAL] And the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Patient is [PII], [PII] is the date of birth.
[AGENT][NEUTRAL] Mhm
[AGENT][POSITIVE] Thank you. My pleasure to help you with that claim status. What is that date of service?
[CUSTOMER][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Data service 3623.
[CUSTOMER][NEUTRAL] Uh, total charge 665.
[AGENT][NEUTRAL] And the name of the facility please, ma'am.
[CUSTOMER][NEUTRAL] Yes ma'am. Pay on Health Services.
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] I can help you with that claim status. We did receive that claim on [PII].
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] And processed on [PII].
[AGENT][NEUTRAL] Now the claim was denied. Benefits are payable only if the major medical provides benefits.
[AGENT][NEUTRAL] And this policy pays for the deductible co-pay or coinsurance. If they happen to go back and re reprocess and apply something to the deductible, co-pay or co-insurance, that claim can be resubmitted for consideration.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, can I get the claim number?
[AGENT][NEUTRAL] Claim number is 354.
[AGENT][NEUTRAL] 0261.
[CUSTOMER][NEUTRAL] Thank you. um, would you happen, would you be able to send me a duplicate, uh, EOB?
[AGENT][NEUTRAL] I can now we also have a provider portal.
[AGENT][POSITIVE] It's secured
[CUSTOMER][NEUTRAL] I'll take that. What is it?
[AGENT][NEUTRAL] It's SEC.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] You are ED.
[AGENT][NEUTRAL] [PII].
[AGENT][POSITIVE] And if you want to, um, I can help you register real quick it is quicker and easier to just to get that EOB online.
[CUSTOMER][NEUTRAL] Oh alright let me go to it then let's see.
[AGENT][NEUTRAL] Then you're gonna choose the user and your medical or dental provider.
[CUSTOMER][NEUTRAL] Let me see is secure.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, let's see.
[AGENT][NEUTRAL] And then you can put in
[CUSTOMER][NEUTRAL] OK, no user.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh, OK, so I, um, let's see, I'm an individual employer I don't know.
[AGENT][NEUTRAL] You're gonna use the bottom one. I'm a medical or dental provider.
[CUSTOMER][NEUTRAL] Bye bye.
[CUSTOMER][NEUTRAL] Right, OK, thank you. Oh, tax ID number, let's get that in there.
[AGENT][NEUTRAL] Tax ID.
[AGENT][NEUTRAL] And when it gets to patient account number, let me know and I can give that to you.
[CUSTOMER][NEUTRAL] And [PII]
[CUSTOMER][NEUTRAL] Oh OK, uh, um, it's, it's, uh, it's asking for it.
[AGENT][NEUTRAL] OK, it's A as in apple, 1237191. So that's gonna be the uh patient account number listed in box 26 on the HPA.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It's with your facility.
[CUSTOMER][NEUTRAL] Oh all right then.
[AGENT][NEUTRAL] And then
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Take
[CUSTOMER][NEUTRAL] And then a password, um.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Yeah, that's it's successfully created, uh, and I I should be able to use it right then and there.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Absolutely you can go back to that website and sign in.
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] And then you're gonna
[CUSTOMER][POSITIVE] Thank you. OK, so then I, and then, so I can just print it from there myself.
[AGENT][NEUTRAL] You certainly can. So if you go to the quick access and put in the patient's name and I think it's date of birth maybe.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK I should say I think.
[AGENT][NEUTRAL] Mhm. Can someone give you the claim number.
[CUSTOMER][NEUTRAL] Oh wait, I typed this.
[CUSTOMER][NEUTRAL] I typed my password in wrong. OK, so quick access and you said claim number. OK, that was the one you just gave me 354-0261?
[AGENT][NEUTRAL] Mhm so go ahead and put that in. Let's make sure you can get that EOB.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] If you don't have the claim number, you would use option 2.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Claim status.
[CUSTOMER][NEUTRAL] OK, so first name [PII].
[CUSTOMER][NEUTRAL] 2
[CUSTOMER][NEUTRAL] Yep, it's there so if I just click on the claim, the hyperlink that'll pull up the EOB.
[AGENT][POSITIVE] That's right.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So you can also um submit claims online as well as claim status.
[CUSTOMER][NEUTRAL] OK, so I see nothing else you need to file a claim. OK, yeah, it's coming up.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Perfect. OK, well thank you so much then, because I mean this is perfect. I can just go. You don't even have to worry about it. I can just go ahead on and use this and send it to my payment posting team.
[AGENT][POSITIVE] That's right.
[CUSTOMER][POSITIVE] Thank you so much again. I appreciate it. Have a good one.
[AGENT][POSITIVE] It's been my pleasure and thank you for calling APL Sonia. I hope you have a wonderful day.
[CUSTOMER][NEUTRAL] You do the same.
[AGENT][POSITIVE] Thank you. Bye-bye.
[CUSTOMER][POSITIVE] You're welcome. Bye-bye.