AccountId: 011433970860
ContactId: acf0dc07-8fee-48c8-96fd-82f485c6c583
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 339679 ms
Total Talk Time (AGENT): 108714 ms
Total Talk Time (CUSTOMER): 154909 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/13/acf0dc07-8fee-48c8-96fd-82f485c6c583_20250513T13:54_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Yes, hi, my name is [PII] and I'm calling from Jackson Memorial Hospital in regards to a claim.
[AGENT][NEUTRAL] OK, I can verify claim status for you. And Ms. [PII], what's that policy number, please?
[CUSTOMER][NEUTRAL] OK, policy number is.
[CUSTOMER][NEUTRAL] 024.
[CUSTOMER][NEUTRAL] 329.
[CUSTOMER][NEUTRAL] 32 ML 8.
[CUSTOMER][NEUTRAL] 18635
[AGENT][NEUTRAL] OK, thank you. And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And the patient's name, date of birth?
[CUSTOMER][NEUTRAL] Um, it looks like the first name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you. And you say you're calling for a claim status, correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And what was the date of service and the amount of the charge?
[CUSTOMER][NEUTRAL] Data services on [PII] through [PII] for $10,421.35.
[AGENT][NEUTRAL] OK, thank you. And do you have the balance after primary has processed the claim?
[CUSTOMER][NEUTRAL] $6,0026 and hold on $6,0026.40.
[AGENT][NEUTRAL] OK, thank you, ma'am and you're calling from?
[CUSTOMER][NEUTRAL] Jackson Memorial Hospital.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And while I'm looking up claim information just to let you know we do have an online service center where providers can check claim status as well as print out the EOB. That site is at [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And Ms. [PII], I'm showing.
[CUSTOMER][NEUTRAL] OK, you said it's secured.
[AGENT][NEUTRAL] Uh-huh, secured [PII].
[CUSTOMER][NEUTRAL] Secured what?
[CUSTOMER][NEUTRAL] Mhm mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and I show the claim processed as needing primary insurance EOB.
[CUSTOMER][NEUTRAL] OK, but that was sent to you guys. Like, come on, yeah, I mean, we're billing you secondary, so we know that you need the EOB from, from the primary. They had two other claims that we billed on the same day with the EOB that's already processed, so I don't, I really don't get it, and the patient is like on our backs and it just doesn't make sense, um, to me why you not you in general, but why you would be asking for the secondary, um, the primary EOB.
[CUSTOMER][NEUTRAL] Because it definitely was sent.
[AGENT][NEUTRAL] Let me see what we received. Give me one moment.
[AGENT][NEUTRAL] Uh, no, ma'am. I'm looking at the claim information received, and we have not received the primary EOB.
[CUSTOMER][NEUTRAL] OK, can it be faxed sent to you guys or emailed or?
[AGENT][POSITIVE] Yes ma'am, I can give you a fax number when you're ready.
[CUSTOMER][NEUTRAL] OK, I think we, uh, I'm looking at the notes now I think I just saw a fax number [PII].
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, because, uh, OK, yeah, requesting that we build secondary payer ID, um, OK.
[CUSTOMER][POSITIVE] Alrighty alright thank you.
[AGENT][POSITIVE] Alright, you're welcome thanks for calling.
[CUSTOMER][NEUTRAL] And you guys received the claim on what day? I'm, I'm sorry, when did you guys receive the claim?
[AGENT][NEUTRAL] Uh, give me a moment.
[CUSTOMER][NEUTRAL] And what's the claim number?
[AGENT][NEUTRAL] Uh, claim number is 359-8733. Claim received on [PII].
[CUSTOMER][NEUTRAL] And how did you receive it? Paper or was it sent electronic electronically?
[AGENT][NEUTRAL] Uh, let me see if it shows.
[CUSTOMER][NEUTRAL] Because I see the request that says please build secondary American Public Life um electronically payer ID 60801 and we do have the ability to attach.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][POSITIVE] We do have the ability to attach the EOB even when we build it electronically.
[AGENT][NEUTRAL] Well, it really doesn't show, but it looks like um,
[AGENT][NEUTRAL] Give me one moment.
[CUSTOMER][NEUTRAL] It was built electronically on [PII] and turned around and build paper on 415.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Well, it really doesn't state, um, on our end if it was mailed or sent electronically. No, ma'am.
[CUSTOMER][NEUTRAL] How you received it.
[CUSTOMER][NEUTRAL] OK, OK, alrighty, is there a reference number?
[AGENT][NEUTRAL] No, ma'am, if you like, you may use my name in today's date.
[CUSTOMER][NEUTRAL] And your name again is?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome. uh, thank you for calling APL. Have a great day.
[CUSTOMER][POSITIVE] Have a good day mhm.
[CUSTOMER][NEUTRAL] Mhm bye.
[AGENT][NEUTRAL] I'm fine.