AccountId: 011433970860
ContactId: af2d5f28-723b-4aae-a53d-b945d31ef210
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 473149 ms
Total Talk Time (AGENT): 137821 ms
Total Talk Time (CUSTOMER): 211694 ms
Interruptions: 3
Overall Sentiment: AGENT=0.9, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/20/af2d5f28-723b-4aae-a53d-b945d31ef210_20250620T19:12_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah, my name is [PII] calling from provider's office to check the claim status.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] What is your name?
[CUSTOMER][NEUTRAL] My name is [PII]
[AGENT][NEUTRAL] What is your call back number [PII]?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Thank you. What is your policy number?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, it's 0245504054.
[AGENT][POSITIVE] I'm so sorry. Can you please repeat that?
[CUSTOMER][NEUTRAL] Yeah, it's 02455054.
[AGENT][NEUTRAL] OK, thank you, one moment.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Yeah, it's [PII]. And the date of birth is [PII].
[AGENT][NEUTRAL] Thank you. You can check also claim status on our secure website at [PII]. That is [PII] and on that website you'll be able to obtain an EOB as well. What is that date of service and total bill amount for claim status?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] What.
[CUSTOMER][NEUTRAL] Yeah, yeah, it's [PII] and the bill amount is $1,112 even.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Yeah, sure.
[AGENT][NEUTRAL] OK, can you verify the procedure code or codes billed for this service day for the member?
[CUSTOMER][NEUTRAL] Procedure code.
[CUSTOMER][NEUTRAL] It's
[CUSTOMER][NEUTRAL] Uh, there are two procedure codes. It's 93456 and another one is 99152.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, thank you very much for the information that helps. Um, it shows that the claim was received on [PII]. It was processed on [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] [PII]. OK. And what is
[AGENT][NEUTRAL] Process [PII], yes.
[CUSTOMER][NEUTRAL] Yeah, claim number?
[AGENT][NEUTRAL] OK, we're requesting the explanation of benefits. The claim number is 361-1784.
[CUSTOMER][NEUTRAL] Sorry, can you please repeat it once again?
[AGENT][NEUTRAL] 361-1784.
[CUSTOMER][NEUTRAL] Yeah, 361-1784. OK. And what is the claim that? Is it paid or is it in process?
[AGENT][NEUTRAL] We are requesting the explanation of benefits.
[CUSTOMER][NEUTRAL] OK. So it's still in process.
[AGENT][NEUTRAL] It processed on [PII].
[AGENT][NEUTRAL] We are requesting the explanation.
[AGENT][NEUTRAL] So from the primary.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK, from primary, but, uh, uh, in our system, the uh
[CUSTOMER][NEUTRAL] The APL Medicare is primary.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] We are not primary.
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] OK, so you are the secondary.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] And uh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, one second, let me check in my system.
[CUSTOMER][NEUTRAL] May I know what is the claim status?
[AGENT][NEUTRAL] I'm sorry.
[AGENT][NEUTRAL] [PII], the claim status is we are requesting the explanation of benefits from the primary.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, uh, how we can send you the primary UV.
[AGENT][NEUTRAL] OK, you can fax it to us. Our fax number is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yeah, it's [PII].
[AGENT][NEUTRAL] We have a payer ID.
[CUSTOMER][NEUTRAL] I don't
[CUSTOMER][NEUTRAL] Uh, what is the payer ID?
[AGENT][NEUTRAL] 60801.
[CUSTOMER][NEUTRAL] 60801.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Yeah, uh, and anything else in this, uh, addition.
[AGENT][NEUTRAL] Of course, we have a mailing address. Would you like that as well?
[CUSTOMER][NEUTRAL] Uh, sorry?
[AGENT][NEUTRAL] Would you like our mailing address to submit the claim as well?
[CUSTOMER][NEUTRAL] What did you say?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, and uh can you please tell your, spell your name?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] What is the initial?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] And what would be the call reference number in?
[CUSTOMER][NEUTRAL] I
[AGENT][POSITIVE] It will be my name and today's date, please, [PII], anything else I can help you with?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Uh, no, [PII]. That's not only. Thank you for giving your valuable time. Have a good day.
[AGENT][POSITIVE] Thank you for calling APL. Take care. Bye.