AccountId: 011433970860
ContactId: 9381e3aa-23b4-4ec0-bcf1-13f62581cf77
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 221630 ms
Total Talk Time (AGENT): 79088 ms
Total Talk Time (CUSTOMER): 74927 ms
Interruptions: 1
Overall Sentiment: AGENT=-0.3, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/30/9381e3aa-23b4-4ec0-bcf1-13f62581cf77_20250430T13:57_UTC.wav
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[AGENT][NEUTRAL] Calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, [PII]. This is [PII] calling from the provider's office to check on the claim status.
[AGENT][NEUTRAL] Sure, [PII], I can assist you with that. Can I have a callback number for you and that policy number?
[CUSTOMER][NEUTRAL] Sure. The callback number will be [PII]. It's a direct line.
[CUSTOMER][NEUTRAL] And the policy ID?
[CUSTOMER][NEUTRAL] It's 249-691-1.
[AGENT][NEUTRAL] Could you verify the patient's name and date of birth for me, [PII] and I'll be able to assist you.
[CUSTOMER][NEUTRAL] Sure. Uh my name is [PII] and date of birth is on [PII].
[AGENT][NEUTRAL] And you're calling to check the status of a claim for what date of service?
[CUSTOMER][NEUTRAL] Yeah, the date of service is on [PII].
[CUSTOMER][NEUTRAL] And the total bill amount is $5,543 in even.
[AGENT][NEUTRAL] Thank you. So it looks like we're requesting the EOB to the primary insurance company. Are you aware that the member has a primary insurance company?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] So upon checking, I just found that uh United Healthcare is the primary which has been paid. So, let me check if we have sent any of the EOB. Just give me a minute.
[AGENT][NEUTRAL] That we need a OK because we are requesting a um a more detailed ELB showing what went towards the towards the deductible copay and co-insurance.
[CUSTOMER][NEUTRAL] OK. So just let me check.
[CUSTOMER][NEUTRAL] Yeah, so we have, upon checking, we have seen the EU be on [PII]. Have you received that?
[AGENT][NEUTRAL] Give me one moment.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] The last claim we received was [PII]. It was processed [PII], and we're requesting a more detailed EOB.
[CUSTOMER][POSITIVE] OK, thank you so much for that. So how can we send the UP? What is the fax number?
[AGENT][NEUTRAL] The fax number is [PII].
[AGENT][NEUTRAL] Give me one moment, let me make sure I give you the correct one.
[AGENT][NEUTRAL] Fax number is [PII]. That's [PII]. Attention claims department.
[CUSTOMER][POSITIVE] OK, thank you so much for that. And what would be the family funding limit to send the primary year be?
[AGENT][NEGATIVE] There's no timely filing.
[CUSTOMER][NEUTRAL] OK. And can I get the claim number as well as the call reference number?
[AGENT][NEUTRAL] The claim number is 357-5182.
[AGENT][NEGATIVE] It's 357-5182. Unfortunately, [PII], we do not provide reference numbers.
[AGENT][NEUTRAL] You can feel free to use my name in today's date as a reference. [PII].
[CUSTOMER][NEUTRAL] OK. So, can you please spell out your name?
[CUSTOMER][POSITIVE] Gotha. Thank you so much for that. Have a great day. Take care. Bye-bye.
[AGENT][POSITIVE] Thanks for calling APO. You have a great one as well, [PII]. Goodbye.
[CUSTOMER][NEUTRAL] Mhm.