AccountId: 011433970860
ContactId: 9273dbc5-8473-4685-94a1-e44faf27fec1
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 240509 ms
Total Talk Time (AGENT): 101956 ms
Total Talk Time (CUSTOMER): 85088 ms
Interruptions: 1
Overall Sentiment: AGENT=0.4, CUSTOMER=-0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/19/9273dbc5-8473-4685-94a1-e44faf27fec1_20250619T19:41_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Hi, was your name [PII]?
[AGENT][NEUTRAL] Uh, [PII].
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I needed to get status, please.
[AGENT][NEUTRAL] Uh, claim status?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][POSITIVE] OK, I can check on that for you. [PII], can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII] hold on that's the facility hold on.
[CUSTOMER][NEUTRAL] Hello.
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Yeah, [PII]. I have a moment.
[AGENT][NEUTRAL] OK, thank you and do you have that policy number?
[CUSTOMER][NEUTRAL] Wait, hold on, it's 01449246 ML 5. What is it?
[AGENT][NEUTRAL] OK and then what was the name and date of birth for the member please?
[CUSTOMER][NEUTRAL] Um, the patient's name is [PII] Date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you for verifying that. What was the date of service for this claim?
[CUSTOMER][NEUTRAL] What's the ID number.
[CUSTOMER][NEUTRAL] [PII] or [PII]?
[CUSTOMER][NEUTRAL] What's the patients in for.
[AGENT][NEUTRAL] OK, that was [PII] for 125?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, thank you. One moment please.
[CUSTOMER][NEUTRAL] OK, what's the date of birth? are you?
[CUSTOMER][NEUTRAL] [PII], what's the patient's name?
[CUSTOMER][NEUTRAL] OK, what is she calling for?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Is this with uh the Campbell Urgent Care?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK thank you one moment.
[CUSTOMER][NEUTRAL] Alright, go ahead.
[AGENT][NEUTRAL] OK, so we did receive this claim from the provider, uh, however, it does appear to be a duplicate of a previously submitted claim, uh, we had already paid that benefits to the insured.
[CUSTOMER][NEUTRAL] Right
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEGATIVE] Why are you guys paying the insured instead of us?
[AGENT][NEUTRAL] If they were the ones who filed the claim before the provider did, then we would send that payment information to them.
[CUSTOMER][NEUTRAL] Do you, can you let me know when you paid it and how much you paid?
[AGENT][NEUTRAL] It was the $125.
[AGENT][NEUTRAL] Uh, give me just a moment. Let me take a look.
[CUSTOMER][NEUTRAL] You pay a whole $125 for this patient?
[AGENT][NEUTRAL] Yes, they submitted that claim information to us uh looks like that was on.
[CUSTOMER][NEUTRAL] Oh, because they paid their copay. OK, go ahead.
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] Yes, it's who we pay depends on if you know if the provider sends us that information or the insured whoever gives us that information first, that's who we would send that bene benefit information to that payment.
[CUSTOMER][NEGATIVE] Yeah, but that's, you know, honestly, this is it, you know, I get that part, but it's not fair because the patients never turn around and pay us.
[AGENT][NEUTRAL] It's their policy and that's how this policy works so uh they were the ones who did that and apparently it was uh just before this y'all filed the claim.
[CUSTOMER][NEUTRAL] OK, so you guys issue payment for the payment?
[AGENT][NEUTRAL] If you need a copy of this EOB that states that information I can send that to you.
[CUSTOMER][NEUTRAL] Oh, it has all the paid information on it?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] You're the best. Can you fax it to me, please?
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Yeah, what's that fax number for you?
[CUSTOMER][NEUTRAL] It's gonna be the same as my phone number [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, got it. I'll go ahead and send that now. You should get it within about 10 minutes or so. And was there anything else I could help you with? Did you need that claim number?
[CUSTOMER][NEUTRAL] That's it.
[CUSTOMER][POSITIVE] That's it for now thank you.
[AGENT][POSITIVE] Alright well thanks for giving us a call thank you have a great rest of your day.