AccountId: 011433970860
ContactId: 9f1c1587-7d45-4408-86c8-387f540cf6a9
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 503480 ms
Total Talk Time (AGENT): 220233 ms
Total Talk Time (CUSTOMER): 98063 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/18/9f1c1587-7d45-4408-86c8-387f540cf6a9_20250218T13:26_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII] calling for Osno Medical Equipment to check on my claim status.
[AGENT][NEGATIVE] I, I'm so sorry, we have a terrible connection. Just one moment, I can barely understand you.
[CUSTOMER][NEUTRAL] No?
[AGENT][POSITIVE] That's a little better.
[CUSTOMER][NEUTRAL] Yes, my name is [PII]. I'm calling for Osno Medical Equipment to check on a claim status.
[AGENT][NEUTRAL] OK, [PII], you have one claim to check status on, is that correct?
[CUSTOMER][NEUTRAL] I got 2 data servers on a single patient.
[AGENT][NEUTRAL] I'm very sorry, [PII], but you sound like you're underwater. Just one moment. I don't know if it's my phone or yours. One moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII], can you hear me?
[CUSTOMER][NEUTRAL] Yes, I can. Can I?
[AGENT][NEUTRAL] Uh, yes, sir, at the moment. So you
[CUSTOMER][NEUTRAL] Am I audible now?
[AGENT][NEUTRAL] Yes, that's better. And what is your callback number?
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII] and it's a direct line.
[AGENT][NEUTRAL] Thank you. And you said you have 1 patient with 2 dates of service, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Yes, I can help you and [PII], you will use my name that I gave you?
[AGENT][NEUTRAL] Which is [PII] Mhm. I'll look for your call reference number. Also, [PII], any information that I provide for you on any of the claims that I check will be a verification of benefits and not a guarantee of payment. And lastly, [PII], if you need a copy of the explanation of benefits if we do have the claim on file, you may print those by going to our portal.
[CUSTOMER][POSITIVE] Yes, got it.
[AGENT][NEUTRAL] And that is located at [PII].
[CUSTOMER][NEUTRAL] OK, got it.
[AGENT][NEUTRAL] And, OK, and what is your patient's policy number?
[CUSTOMER][NEUTRAL] Policy number is 1265678.
[AGENT][POSITIVE] Thank you one moment.
[AGENT][NEUTRAL] OK, just one moment please, [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And your patient's name, please and date of birth?
[CUSTOMER][NEUTRAL] Patient's name is [PII]. Date of birth is [PII].
[CUSTOMER][NEUTRAL] Of [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And the first day of service and total bill amount, please.
[CUSTOMER][NEUTRAL] First data service is [PII] for $441.31.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, [PII], so we've received this claim more than once. The most recently received claim was denied as a duplicate. Give me just one moment to provide you the original claim information.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so the original claim was received on [PII]?
[AGENT][NEUTRAL] It was processed and denied on [PII].
[AGENT][NEUTRAL] The claim number is 3552091.
[AGENT][NEUTRAL] And the reason for the denial is that we need the primary insurance company's explanation of benefits.
[CUSTOMER][NEUTRAL] Can you see the primary you'll be on the duplicate claim claimed as a duplicate.
[AGENT][NEGATIVE] No, sir, we did not. We did not.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Can I get the
[CUSTOMER][NEUTRAL] Mailing address, family filing limit, and fax number if you have any.
[AGENT][NEUTRAL] The mailing address is the same as claims [PII]. The zip code is [PII], Attention claims.
[AGENT][NEUTRAL] The claims fax number is [PII]. Also attention claims.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And the timely filing limit to submit the primary UBs.
[AGENT][NEUTRAL] There's no timely filing for that?
[AGENT][NEUTRAL] And what is your next data service, [PII], and total bill amount?
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][POSITIVE] And the bill amount is just good.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] $621.34.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And you did say 1212 of [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, this claim was also received multiple times. The most recent one was that was received was denied as a duplicate. One moment and I'll provide you the original claims information.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It was received on [PII], processed and denied on [PII].
[AGENT][NEUTRAL] The claim number is 353-2863.
[AGENT][NEGATIVE] And it was also denied because we need the primary insurance explanation of benefits.
[CUSTOMER][NEUTRAL] OK, there's no primary you'll be on the recent claim that was generated as a duplicate.
[AGENT][NEUTRAL] There is not
[CUSTOMER][NEUTRAL] OK, and there is no time defining limit, right?
[AGENT][NEUTRAL] Wait
[AGENT][NEUTRAL] That is correct. You only need to send the explanation of benefits.
[CUSTOMER][NEUTRAL] No claim form required.
[CUSTOMER][NEUTRAL] Just the explanation of benefits with the claim number attached.
[AGENT][NEUTRAL] Yes sir.
[AGENT][NEUTRAL] Yes, only the.
[AGENT][NEUTRAL] Yes, only the needed piece of information.
[AGENT][NEUTRAL] You only need to send the primary EOB.
[CUSTOMER][NEUTRAL] OK, got it.
[AGENT][NEUTRAL] And if you need a copy of either of these explanation of benefits, [PII], you may print them by going to our portal at [PII].
[CUSTOMER][NEUTRAL] OK. Is there any call reference now for today's call?
[AGENT][NEUTRAL] Yes sir, you would need to use my name that I gave you along with today's date.
[CUSTOMER][POSITIVE] OK, [PII], that's it for today. Thank you so much for your assistance. You have a wonderful rest of your day.
[AGENT][NEUTRAL] OK, wait.
[AGENT][POSITIVE] Well, you're very welcome [PII]. It was my pleasure and thank you again for calling APL. I hope you have a very nice day also.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye.