AccountId: 011433970860
ContactId: af1caeeb-144c-4e83-b563-6b0e90bcb7a8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 264290 ms
Total Talk Time (AGENT): 96698 ms
Total Talk Time (CUSTOMER): 144261 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/21/af1caeeb-144c-4e83-b563-6b0e90bcb7a8_20250121T17:00_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling American Public Life. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] A
[CUSTOMER][NEUTRAL] Um, yes, I'm not sure if I pressed the right, um, button, but I'm Doctor [PII] with Innovation Behavioral Health, and I had submitted a claim and I need to pull that claim because it was erroneously sent.
[AGENT][NEUTRAL] OK, do you have a policy number?
[CUSTOMER][NEUTRAL] Yes, the policy number.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] 01816171
[CUSTOMER][NEUTRAL] And I just knew it a couple of days ago, so.
[CUSTOMER][NEUTRAL] If it's received, it may be received today or tomorrow.
[AGENT][NEUTRAL] Doctor [PII], may I have a good callback number for you?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And may I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Her name is [PII].
[CUSTOMER][NEUTRAL] Oh, I got to put my glasses on my contact. [PII].
[CUSTOMER][NEUTRAL] And her date of birth is [PII].
[AGENT][NEUTRAL] Thank you for verifying that information. Please be advised that verification of coverage does not guarantee the payment of a claim. And this was faxed, was it mailed? Was it uploaded?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It was mailed. It was mailed, and it contains a claim for [PII], but.
[CUSTOMER][NEUTRAL] And I don't know in processing her it was paid by her.
[CUSTOMER][NEUTRAL] Other insurance United Behavior Health.
[AGENT][NEUTRAL] And it was paid in full?
[CUSTOMER][POSITIVE] Yes, ma'am. Yeah, it was paid according to my agreement with uh United Behavioral Health. Yes, ma'am.
[AGENT][NEUTRAL] So what
[AGENT][NEUTRAL] So was there a claim um EOB attached from United Health?
[CUSTOMER][NEUTRAL] It was and it had that um that they did not pay but looked like she has two different um
[CUSTOMER][NEUTRAL] It's something when you're not Health if if one don't pay then they send it over to another policy or something.
[CUSTOMER][NEUTRAL] And there's a uh a long delay is what it what it is but they quickly um they sent that and then they end up sending the check.
[AGENT][NEUTRAL] OK. So what will
[CUSTOMER][NEUTRAL] So the, so there's gonna, uh, there's gonna be an EOB saying that they did not pay the claim, but they did.
[AGENT][NEUTRAL] OK, so what will happen on our end because as of today, I'm not showing that we have received it, but once it comes in with that EOB, the ELB is not showing a co-pay or co-insurance and or deductible, so it will deny anyway. It will not process, it will deny as primary did not pay. Now, if you need it.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Right, and
[CUSTOMER][NEUTRAL] Go ahead.
[AGENT][NEUTRAL] If you need it for your records to state that the primary insurance paid in full, I would submit that corrected EOB to shows primary paid in full.
[CUSTOMER][NEUTRAL] OK, so submit that to you guys.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, is there a fax number where I can do that?
[AGENT][NEUTRAL] Yes, ma'am. The fax number is 877.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 365.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 94
[CUSTOMER][NEUTRAL] Hold on, this PN stop right. I'm sorry, Ping stop right.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 877.
[AGENT][NEUTRAL] 365.
[AGENT][NEUTRAL] 942-3 attention claims.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alrighty, [PII] attention claims.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][POSITIVE] I will take care of that today. Thank you so much.
[AGENT][POSITIVE] Doctor [PII], you're so welcome. Is there anything else I can assist you with?
[CUSTOMER][POSITIVE] No, ma'am, you've been wonderful. You enjoy the rest of your day.
[AGENT][NEUTRAL] Well
[AGENT][POSITIVE] You as well, Dr. [PII], and thank you for calling American Public Life. Have a great day. Bye-bye.
[CUSTOMER][NEUTRAL] You too bye bye.