AccountId: 011433970860
ContactId: b36fe04c-aaeb-44f7-98a0-7b08fd76b877
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 287779 ms
Total Talk Time (AGENT): 128777 ms
Total Talk Time (CUSTOMER): 103013 ms
Interruptions: 2
Overall Sentiment: AGENT=0.9, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/07/b36fe04c-aaeb-44f7-98a0-7b08fd76b877_20250407T18:05_UTC.wav
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[AGENT][NEUTRAL] Afternoon, thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] [PII], how are you today?
[AGENT][NEUTRAL] I'm fine, and yourself?
[CUSTOMER][NEUTRAL] Good thanks um I'm calling from Professionalle services. I was just hoping to
[CUSTOMER][NEUTRAL] Check the status of a claim.
[AGENT][NEUTRAL] OK, you're needing to check claim status for a member, is that correct?
[CUSTOMER][POSITIVE] That is correct.
[AGENT][POSITIVE] Yes ma'am, I can help you with that and who am I speaking with please?
[CUSTOMER][NEUTRAL] Yeah my name is [PII].
[AGENT][POSITIVE] Thank you and [PII], what's a good callback number for you?
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, thank you. And [PII], what is your patient's policy number?
[CUSTOMER][NEUTRAL] It is.
[CUSTOMER][NEUTRAL] 02576031.
[AGENT][POSITIVE] OK, thank you one moment.
[AGENT][NEUTRAL] And R you any information that I do provide for you today would be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth?
[CUSTOMER][NEUTRAL] The patient's name is uh [PII].
[CUSTOMER][NEUTRAL] Uh the last name is [PII] and then uh date of birth is [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, thank you. And what is the date of service and total bill amount please?
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] It's uh [PII] and $275.
[AGENT][NEUTRAL] 275. OK. One moment.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] OK, and you did say [PII], is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, we have not received a claim on the supplemental policy for him for that data service.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That is what I thought, but I just wanted to be sure, um, can I just confirm because I'll be sending it electronically, um, is the payer ID, what is the payer ID?
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] 60801. Now, with this type of policy, [PII], we must also receive a copy of his primary insurance company's explanation of benefits for that data service also.
[CUSTOMER][NEUTRAL] 0
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then when our yeah.
[CUSTOMER][NEUTRAL] OK, yeah, I don't think they forwarded the claim, so.
[AGENT][NEUTRAL] I'm sorry.
[AGENT][NEUTRAL] Yeah. So would you say declining the primary EOB?
[CUSTOMER][NEUTRAL] OK, um, what would be the best way to.
[CUSTOMER][NEUTRAL] The claiming OK and the best way to send that you be, would that be like an email or a fax?
[AGENT][NEUTRAL] OK, you would have to send it via fax. We can't accept claims information via email. The fax number, do you have that?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Sure, yeah, what's the fashion.
[CUSTOMER][NEUTRAL] Um, let me write that down. OK, go ahead.
[AGENT][NEUTRAL] The claims fax number, which is a secure line is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] 942-3 attention claims.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] And then once we have processed the claim.
[AGENT][NEUTRAL] Here at APO right we do have a portal in which you should be able to check claim status for us by going to secured.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Perfect. OK, awesome, I will do that. Thank you so much for your help.
[AGENT][POSITIVE] Oh, you're certainly so welcome. Is there anything else I can help you with?
[CUSTOMER][NEUTRAL] No, that's everything. I'm sorry, what was your name again?
[AGENT][NEUTRAL] [PII], and my name and today's date will be your call reference number if you need one.
[CUSTOMER][POSITIVE] Beautiful. That was my next question. Thank you so much for your help, [PII]. Have a wonderful day.
[AGENT][POSITIVE] OK, well, you're welcome. I hope you do too, [PII], and thank you again for calling APL.
[CUSTOMER][POSITIVE] Sure, take care.
[AGENT][NEUTRAL] Um, bye bye.