AccountId: 011433970860
ContactId: 9c176b03-a9a8-49fc-b152-9420c0d1b42b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 380299 ms
Total Talk Time (AGENT): 118254 ms
Total Talk Time (CUSTOMER): 177879 ms
Interruptions: 1
Overall Sentiment: AGENT=0.7, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/04/9c176b03-a9a8-49fc-b152-9420c0d1b42b_20250204T19:57_UTC.wav
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[AGENT][POSITIVE] Thank you for calling
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] May I help you?
[CUSTOMER][NEUTRAL] Hi there, my name is [PII].
[CUSTOMER][NEUTRAL] And I received a letter from you all I guess and don't laugh at me because I don't know exactly how it works but I think you all are like secondary coverage for me through my employer.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And I received a letter from you all requesting that I send you the um please provide copies of your explanation of benefits from your primary insurance cover carrier.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So I recently um had a partial hysterectomy.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Can I, is there somewhere that I can scan and email that to you all?
[AGENT][NEUTRAL] OK, give me one second because I'll need to get your policy number and then get you verified and then we can proceed.
[CUSTOMER][POSITIVE] OK perfect.
[AGENT][NEUTRAL] So do you have your policy number?
[CUSTOMER][NEUTRAL] Uh-huh, it's 02389020.
[AGENT][POSITIVE] And a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][POSITIVE] I'm gonna give this to you too. You can just do that later. Don't worry about it right now.
[CUSTOMER][POSITIVE] Because I know we got to get that call.
[AGENT][NEUTRAL] And Charity you verify your date of birth and mailing address?
[CUSTOMER][NEUTRAL] Uh [PII] and mailing address is [PII].
[AGENT][NEUTRAL] And do you have an email address on file that you can verify?
[CUSTOMER][NEUTRAL] Um, my personal is [PII].
[AGENT][NEUTRAL] OK, [PII] for your first and last names, [PII], OK, so [PII]?
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] It's kind of a tongue twister.
[CUSTOMER][NEUTRAL] Yes, it is.
[AGENT][NEUTRAL] OK, thank you for verifying the information. OK, so you said that you received, uh, was it an explanation of benefits that you received?
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Well, I received this um.
[CUSTOMER][NEUTRAL] Let me see what it says. Um, I don't know what it says really on the front. It just has my information. This product does not have provider benefits have not been reduced. It asked me on yeah, explanation of benefits, and it just says please provide copies of your explanation of benefits from your primary insurance carrier, which I believe I received today.
[AGENT][NEUTRAL] Is there a policy
[AGENT][NEUTRAL] OK, is there a claim number on the document that you're looking at?
[CUSTOMER][NEUTRAL] There's a reference number, which is the same as the um policy number. Oh, there's a claim number 35.
[AGENT][NEUTRAL] Policy.
[AGENT][NEUTRAL] OK, so, OK.
[CUSTOMER][NEUTRAL] 35498004
[AGENT][NEUTRAL] Got it.
[AGENT][NEUTRAL] And so there should be a date of services that for [PII]?
[AGENT][NEUTRAL] Date of service?
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] Well, I actually have the procedure.
[AGENT][NEUTRAL] The hospital a day.
[AGENT][NEUTRAL] Yeah, the date you were in the hospital.
[CUSTOMER][NEUTRAL] Yes, that's what it, well, the actual date I was, um, yes, that's what date is on here, you are correct.
[AGENT][NEUTRAL] OK. And so,
[CUSTOMER][NEUTRAL] But my procedure was not actually until um the actual procedure was [PII]. That was the day that I went and they had to draw blood.
[AGENT][NEUTRAL] OK, on the [PII]. Got it.
[CUSTOMER][NEUTRAL] And do my pre-op
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so do you have the uh explanation of benefits for this date of service?
[CUSTOMER][NEUTRAL] Um, no, I don't know if I have one.
[AGENT][NEUTRAL] The primary explanation.
[CUSTOMER][NEUTRAL] Oh, I was like, I don't know that I have one for the [PII] I can keep digging, but I had one from the date of my actual procedure. So that's what I was thinking they wanted.
[AGENT][NEUTRAL] What day was that?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, we did receive um.
[AGENT][NEUTRAL] That information and that's that was processed actually today this charge is from.
[CUSTOMER][NEUTRAL] Um.
[AGENT][NEUTRAL] Associated anesthesiologist.
[AGENT][NEUTRAL] So, but that's apparently the anesthesiologists charge.
[AGENT][NEUTRAL] So we will need the primary ELB for the charge for date of service [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, is there a place that I can send that to?
[AGENT][POSITIVE] You can fax it if you would like. I'll give you, I'll give you that number.
[AGENT][NEUTRAL] Let me know when you're ready.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It's 88877.
[CUSTOMER][NEUTRAL] OK, what is that?
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] 365.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] 942 3.
[CUSTOMER][POSITIVE] Perfect.
[AGENT][NEUTRAL] Attention claims.
[CUSTOMER][POSITIVE] OK perfect.
[AGENT][NEUTRAL] Anything else?
[CUSTOMER][NEUTRAL] No, that'll be it. So I'm gonna fax you the, um, I'm gonna find the explanation of benefits for the date of service on [PII].
[AGENT][NEUTRAL] Right. And then it's from the hospital. Mhm. It's from Saint Francis Hospital.
[CUSTOMER][NEUTRAL] Is what I need to send you.
[CUSTOMER][POSITIVE] OK, I will look for that. OK, I'll look for that one because yeah the one I was thinking you wanted was the one from the actual date of surgery, but OK, I will look for that and send it to you. Thank you so much.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] OK, you're welcome and thanks for calling APL charity. Have a good day.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh huh you too bye bye.