AccountId: 011433970860
ContactId: 915a6636-f5d9-4abe-b700-b966227b009c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 509679 ms
Total Talk Time (AGENT): 190289 ms
Total Talk Time (CUSTOMER): 187915 ms
Interruptions: 1
Overall Sentiment: AGENT=0.3, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/08/915a6636-f5d9-4abe-b700-b966227b009c_20250108T14:16_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, I'm calling to follow up on some secondary claims that were sent over to you guys by fax.
[AGENT][NEUTRAL] OK, sure, I can assist you with claims and may I have your name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you, Ms. [PII]. May I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. May I have the patient's policy number?
[CUSTOMER][NEUTRAL] Yes, that is.
[CUSTOMER][NEUTRAL] Oops. 02455568.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] All right. And may I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] [PII]. Date of birth.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mm perfect thank you and what is the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] Um, the first one is [PII] for $640.
[AGENT][NEUTRAL] OK, let me check on this one and see if we got it.
[CUSTOMER][NEUTRAL] That was faxed on [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right, let's see.
[AGENT][NEUTRAL] OK, and I just need to let you know that for future you can check claim status online through our website at [PII] and that's just optional. And let's see. OK, let me look into this claim right here.
[AGENT][NEUTRAL] On.
[CUSTOMER][NEUTRAL] Actually it was August, uh yeah, it was [PII]. You paid the [PII], the [PII], the [PII], the [PII], but did not pay the [PII] because um.
[CUSTOMER][NEUTRAL] I guess there were 2 pages to um the primary EOB.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, it looks like we already paid that one but let me pull the EV one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, I'm still waiting on the UB to pull up.
[AGENT][NEUTRAL] All right. And this was for um procedure code 97153?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, um, it looks like we processed the claim on [PII] and we send a benefit amount of $10 to the provider.
[CUSTOMER][NEUTRAL] Was that for data service 8-9-2024?
[AGENT][NEUTRAL] Yes, 89 2024.
[CUSTOMER][NEUTRAL] Mm, was that by check?
[AGENT][NEUTRAL] Yes, it was a single check, a paper check. The check number is 2010512.
[CUSTOMER][NEUTRAL] OK, and um, we haven't received that payment. That was [PII].
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] And we're now [PII], does it still say if it's outstanding?
[AGENT][NEUTRAL] Let me see.
[AGENT][NEUTRAL] What is the mailing address that it needs to go to?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, so that's where we send it to, but yeah, it's still saying outstanding.
[CUSTOMER][NEUTRAL] Can it be reissued?
[AGENT][NEUTRAL] I can request for it to be canceled and reissued. Um, let me go ahead and check on the wrist just to make sure that I don't have to get them all. Uh, what is the next one?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] The next one, this was a um a bulk fax on uh let me see here. This is on [PII] with multiple claims. The first date of service is for [PII].
[CUSTOMER][NEUTRAL] For [PII].
[AGENT][NEUTRAL] You said [PII].
[CUSTOMER][NEUTRAL] Yeah, 8:26 to 8:29.
[AGENT][NEUTRAL] They're all separate ones or they're all together in one claim?
[CUSTOMER][NEUTRAL] They were all together on one claim.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I don't have a 26. Uh, let me check 829.
[AGENT][NEUTRAL] I don't have 8:29.
[CUSTOMER][NEUTRAL] 826 through to 829.
[AGENT][NEUTRAL] Mhm. I'm checking day by day just to make sure I don't miss it, um, sometimes.
[AGENT][NEUTRAL] We put the first date and it's just don't come up so OK so I got 26.
[AGENT][NEUTRAL] I don't have 26, I don't have 27, 28.
[CUSTOMER][NEUTRAL] OK, what about, can you check like what came in on the fax on that day on [PII]?
[AGENT][NEGATIVE] If if it's not imaged, I'm not gonna be able to see it, um.
[CUSTOMER][NEUTRAL] OK, what about, let's look here because I definitely got a confirmation that it was delivered. What about [PII]?
[AGENT][NEUTRAL] OK, let's see.
[AGENT][NEUTRAL] And we're still looking under [PII].
[CUSTOMER][POSITIVE] Right, right, correct.
[AGENT][NEUTRAL] OK, all right.
[AGENT][NEUTRAL] No, I have no claims from 93 to 96, no claims.
[CUSTOMER][NEUTRAL] That's why not. I had a confirmation that this was delivered to you guys by fax.
[AGENT][NEUTRAL] It, it, it can say that it was delivered, but it doesn't mean that it gets here.
[AGENT][NEUTRAL] It could have, um, yeah, we.
[CUSTOMER][NEUTRAL] I mean if the confirmation comes through and says the result was OK, that means you guys received it.
[AGENT][MIXED] Not exactly. It just means it went out correctly.
[CUSTOMER][NEUTRAL] I guess I'll have to resend the fax.
[AGENT][NEUTRAL] Mhm, yes, we have not received those to August or um September.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] Yeah, the only one we received was the one that we processed for [PII], which it was the one for the.
[CUSTOMER][NEUTRAL] Um
[AGENT][NEUTRAL] 997153 charge.
[CUSTOMER][NEUTRAL] All right. Hold on.
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] I'm going to.
[CUSTOMER][NEUTRAL] Hold on.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, and that fax number is [PII].
[AGENT][POSITIVE] Yeah, that is correct.
[CUSTOMER][NEUTRAL] OK, um, if I send it now this morning and I call back, when can I call back to be sure that you have it?
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] 24 24 hours, 24 business hours.
[CUSTOMER][NEUTRAL] So, 24 business hours. Why don't you just say 5 business days?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It's just that's the way that we are required to say it's 24 business hours.
[CUSTOMER][NEUTRAL] OK, 3 days.
[CUSTOMER][NEUTRAL] Your name?
[AGENT][NEUTRAL] My name is [PII]. That's [PII] [PII].
[CUSTOMER][NEUTRAL] And the reference is today's date, right?
[AGENT][NEUTRAL] My name in today's date correct.
[CUSTOMER][POSITIVE] OK, thank you so.
[AGENT][POSITIVE] You're welcome. Thank you for calling APL. Have a good day, Ms. [PII].
[CUSTOMER][NEUTRAL] You too.