AccountId: 011433970860
ContactId: 911909f4-e33e-4dd3-95d7-f87dcd58aa92
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 503820 ms
Total Talk Time (AGENT): 178615 ms
Total Talk Time (CUSTOMER): 121997 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/24/911909f4-e33e-4dd3-95d7-f87dcd58aa92_20250124T20:38_UTC.wav
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[AGENT][NEUTRAL] Calling APL, my name is [PII]. How may I assist you today?
[CUSTOMER][NEUTRAL] Um, yes, ma'am, I just wanted to see if I could check um claim status.
[AGENT][POSITIVE] I'll be happy to assist with claim status. May I have your first name please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] And sir, if I can get a good call back number for you.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And what is the policy number?
[CUSTOMER][NEUTRAL] 02510727.
[AGENT][NEUTRAL] I'm sorry, 025.
[CUSTOMER][NEUTRAL] 10727.
[AGENT][NEUTRAL] Patient's name and date of birth.
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] And what is the date of service for the claim?
[CUSTOMER][NEUTRAL] Um, firstly to server they have is [PII].
[AGENT][NEUTRAL] OK, I'm not sure we have that claim on file.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEGATIVE] I've, this is not the first time I've had to call, so I've mailed, I've resent, I've mailed, and I have faxed claims for this patient and you guys don't get them so I don't know what I'm supposed to do.
[AGENT][NEUTRAL] And can you verify the mailing address that you use?
[AGENT][NEUTRAL] How long ago did you do that? Because I do see some claims that have been applied to her account but they haven't been processed. So how long ago did you send them?
[CUSTOMER][NEUTRAL] So you, so you can see claims that you haven't pro, I mean if you can see them then that's all I need to know at this point. If they haven't processed and fine I'll just give it more time.
[AGENT][NEUTRAL] Yeah, OK. I'm looking.
[AGENT][NEUTRAL] I was looking under claims that were processed these they're just sitting out there and no one has touched them, so I don't know what the data services so that's why I'm asking how long ago did you see him?
[CUSTOMER][NEUTRAL] Oh, you can't see that.
[CUSTOMER][NEUTRAL] Just a minute.
[CUSTOMER][NEUTRAL] Um, I did send them on [PII] again.
[AGENT][NEUTRAL] Oh, [PII].
[CUSTOMER][NEUTRAL] I mean December. I, I, I probably did send it no December. I'm sorry.
[CUSTOMER][NEUTRAL] What's the last time that they were sent? [PII].
[AGENT][NEUTRAL] And that was for [PII].
[CUSTOMER][NEUTRAL] There are lots of dates of service. This is just happens to be the first one that I was asking about.
[AGENT][NEUTRAL] OK, I don't see [PII] on here. What's the second day of service?
[CUSTOMER][NEUTRAL] Next date would be [PII].
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Uh, I do have that. What's your tax ID?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] OK, yes, I do see the claim for that for [PII] and we made payment in the amount of.
[AGENT][NEUTRAL] $92.20.
[AGENT][NEUTRAL] And that was on.
[CUSTOMER][NEUTRAL] When did you
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Claim 7664.
[AGENT][NEUTRAL] 64.
[AGENT][NEUTRAL] OK, so it looks like
[AGENT][NEUTRAL] That one was processed today.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It's like a lot of them are processed today.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then there's 3 male numbers, 33 claims that haven't been touched yet.
[CUSTOMER][NEUTRAL] 4
[AGENT][NEUTRAL] But a lot of them were processed today, so we do have the [PII] and that payment was $92.20. Um, what's your next date of service?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] If they, if that one just processed today, I'm gonna take a get and I'll just give the others time and I'll resend the one for [PII] and [PII] then that you guys that you said you don't have.
[CUSTOMER][NEUTRAL] Correct, the [PII]:15 and [PII], you don't have that.
[AGENT][NEUTRAL] Um, let me look at these mail, the ones that haven't been touched and make sure that they're not in there.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Now I can already tell you the one I just pulled up, the first one I just pulled up is for [PII]:19.
[AGENT][NEGATIVE] And it does not have an EOB so I can already tell that's gonna be denied and they're gonna ask you for the EOB for that one.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, so if you wanna send the EOB that's fine. Let me pull up the next one.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, this next one that I'm showing is for 108.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] That they haven't processed yet.
[AGENT][NEUTRAL] Uh, let me look at, but it looks like there's an EOB attached. Let me just make sure.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And then 10:10. I see 10 8 and 10:10.
[AGENT][NEUTRAL] Uh let me look for.
[AGENT][NEUTRAL] Uh,
[AGENT][NEUTRAL] Now for the one for 108 and 1010 I'm only seeing the EOB for 1010 attached to this.
[AGENT][NEUTRAL] Uh,
[AGENT][NEUTRAL] Now let me pull up the last one.
[AGENT][NEUTRAL] OK, the last one doesn't, I'm not showing any.
[AGENT][NEGATIVE] Not showing anything attached to that one. She must be combining these.
[AGENT][NEUTRAL] OK, so yeah, the, the 108 and the 10:10.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Let me make sure that's not a duplicate.
[AGENT][NEUTRAL] 10 8 10:10.
[AGENT][NEUTRAL] No, they're not duplicates. Um.
[AGENT][NEUTRAL] And then 8:19 is not a duplicate either so yeah you'll you'll definitely send the for the ones that didn't have the EOBs on them.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK and then is the best way for me to send these now to mail them or to fax them?
[AGENT][NEUTRAL] I would fax them.
[CUSTOMER][NEUTRAL] OK, I was given [PII] is that correct?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] OK, alright, I will do that then I'll fax over the ones we just spoke about.
[AGENT][NEUTRAL] OK, is there anything else I can assist with today?
[CUSTOMER][POSITIVE] Um, no, that's it. If I could just get a reference number, that would be great.
[AGENT][NEUTRAL] Reference is just my name [PII] last initial [PII], and the date and time of the call.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] Thank you for calling ACL. You have a good day.
[CUSTOMER][NEUTRAL] You too bye.
[AGENT][NEUTRAL] Bye.