AccountId: 011433970860
ContactId: a60b5dc8-6307-46b0-8d8c-096b42fddb95
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 365450 ms
Total Talk Time (AGENT): 167040 ms
Total Talk Time (CUSTOMER): 131206 ms
Interruptions: 2
Overall Sentiment: AGENT=1.1, CUSTOMER=-0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/03/a60b5dc8-6307-46b0-8d8c-096b42fddb95_20250203T17:23_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good morning. Thank you for calling APM. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yes, my name is [PII] and um
[CUSTOMER][NEGATIVE] There's been a bill that's been outstanding for quite some time and uh apparently there's a snafu with the insurance which is you, and I'm trying to get this resolved because I have to have some more blood work I've done.
[AGENT][NEUTRAL] OK, well, I can definitely take a look and see what's going on with the payment. Uh, Mr. [PII], may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you for that. And may I have your policy number?
[CUSTOMER][NEUTRAL] 02559295
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And I have you here. I just need you to verify your date of birth, mailing, and email address.
[CUSTOMER][NEUTRAL] Uh, [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] And the email address should be [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you, and then just your mailing address.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] And that's in [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And OK, so, let me check one thing. Is this the only
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So is the provider saying that they've sent it to us and it's just not being processed because we haven't processed any claims for you, so I'm wondering where they sent it.
[CUSTOMER][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] I don't know.
[AGENT][NEUTRAL] Because I just looked to see like how like just to go through the claims, literally it's blank, like we have not processed one claim for you yet.
[AGENT][NEUTRAL] So that's why I said wait a minute, let me see if there's another one to see if there was like another policy before this one, but no, this is the only one. So now I'm wondering where they sent it.
[CUSTOMER][NEUTRAL] OK, so what, what do you need from me or from them?
[AGENT][NEUTRAL] Let me get, so I'll do this. Let me give you, um, I'll just give you our claims mailing address, our fax number, and our payer ID. So whichever one, if they want to mail it, fax it or send it electronically, that they'll have all three, they can, because there's no like deadline or anything to file the claim, so they can still send it in.
[CUSTOMER][NEUTRAL] Um, now what's going on with my computer?
[CUSTOMER][NEGATIVE] Oh, come on.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] My computer's all locked up. Can you, can you email me that information?
[AGENT][POSITIVE] Oh, take your time. It's fine.
[AGENT][NEUTRAL] Sure, just everything I just said.
[CUSTOMER][NEUTRAL] Uh, yeah, the, the for the claim to process the claims.
[AGENT][NEUTRAL] Yeah, sure.
[AGENT][POSITIVE] Oh, like send the um the address, the fax number. I definitely can.
[CUSTOMER][NEUTRAL] It's, it's like I've got the bill. I can scan that bill and send it to the claims department. Will that work?
[AGENT][NEUTRAL] Well, no, so I don't want you to get denied. So that we're gonna need the um the claim form, the explanation of benefits from your primary insurance, and then the billing from not your bill, like the big bill from the actual provider that your bill comes from, because it has all the coding and everything on it.
[CUSTOMER][NEUTRAL] Now
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I think he went over my head.
[AGENT][NEUTRAL] OK, so, um, to file the claim, you can file it, but if you send just the bill, it's going to be denied because you're gonna need the claim form.
[AGENT][NEUTRAL] The itemized bill from like the doctor, the provider, whoever you went to their billing.
[AGENT][NEUTRAL] It's different
[CUSTOMER][NEUTRAL] OK, it's, it's for Quest Diagnostics. I never got any paperwork.
[AGENT][NEUTRAL] That's what I'm saying. Typically this would come from them, right? Typically, it would, they would be filing the claim.
[CUSTOMER][NEUTRAL] All I got is a bill.
[AGENT][NEUTRAL] But since you asked if you could, I'm just letting you know what's needed to file a claim.
[AGENT][NEUTRAL] But usually this would come from them.
[CUSTOMER][NEUTRAL] OK, well,
[CUSTOMER][NEUTRAL] All right, um, I'll give them a call. [PII], that took 20 minutes just to talk to a person over there.
[CUSTOMER][NEUTRAL] So,
[CUSTOMER][NEUTRAL] Um, OK, go ahead and and send what you're going to send.
[AGENT][NEUTRAL] OK, you want me to send it while we're on the line?
[CUSTOMER][NEUTRAL] No, I can't get into the computer now so go ahead and just send it.
[AGENT][NEUTRAL] OK, so I'll, I'm sending you over an email with our claims mailing address, fax number and payer ID in case and it'll um
[CUSTOMER][NEUTRAL] Whenever
[AGENT][NEUTRAL] show like this is for electronic, this is for fa, so they'll know, so they can file it either way.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, Mr. [PII], was there anything else I can help you with today? It's totally Monday. Is it Monday?
[CUSTOMER][NEUTRAL] [PII], it seems like a Monday.
[CUSTOMER][NEUTRAL] No, um, I've
[CUSTOMER][NEUTRAL] It is. And I, last time I started out like this, the whole damn week was nothing but Mondays. So I'm hoping for the best.
[AGENT][NEUTRAL] Well, let's, let's figure out how to turn this around because I don't want a week on Monday.
[CUSTOMER][NEUTRAL] You got that right. All right, now I gotta try to figure out what's wrong with my computer.
[CUSTOMER][POSITIVE] I appreciate it. Thank you.
[AGENT][POSITIVE] You're very welcome. Well, thank you so much for calling APL. I hope you have a good day.
[CUSTOMER][NEUTRAL] I hope it goes better. Thank you.
[AGENT][POSITIVE] You're welcome. Bye bye.
[CUSTOMER][NEUTRAL] Bye.