AccountId: 011433970860
ContactId: b67cc24e-1bf1-4bcd-ad84-d7660e4bba6b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 325279 ms
Total Talk Time (AGENT): 124183 ms
Total Talk Time (CUSTOMER): 99724 ms
Interruptions: 1
Overall Sentiment: AGENT=0.8, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/18/b67cc24e-1bf1-4bcd-ad84-d7660e4bba6b_20250218T20:17_UTC.wav
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[AGENT][POSITIVE] Good Afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from provider's office to claim center. Could you spell your name, please?
[AGENT][NEUTRAL] My name is [PII]. That's [PII] [PII].
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] Hi, so, I hope you're doing good today.
[AGENT][POSITIVE] I'm good, thank you. And may I have a callback number just in case we get disconnected, Mr. [PII]?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Thank you. And what's the patient's policy number?
[CUSTOMER][NEUTRAL] It's 1578531 M as in Mike, L as in Lima, 7.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] What's the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] It's [PII] and the last name is [PII].
[AGENT][NEUTRAL] Um, that's the date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. May I have the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] It's uh April 7, 2024 and the total bill amount is $3,426 even.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] For future, you can check claim status online through our website at [PII] and that's just optional. And let me pull the EOB one moment.
[CUSTOMER][NEUTRAL] Yeah, so I checked in the portal, but I found that previously one of our agents said the primary will be to process the claim. So that's why I'm calling.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK. Yeah, let me check the most recent one we received because it looks like we processed twice. The first one we asked for the EOB. The second one is a duplicate. I just want to make sure that we don't have that EOB.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And let's see. OK, so that is correct. We only received one page which which it was to you before, so we have not received the EOB as of today.
[CUSTOMER][NEUTRAL] OK, could you tell me the claim is your date, so.
[AGENT][NEUTRAL] Um, when you say the claim issue date, you mean the day we received the claim and the claim process date?
[CUSTOMER][NEUTRAL] Yeah, I'm asking the claim received date and processed date.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. So, um, we have received the claim [PII], process the claim [PII].
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] So it is uh is healing process.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Is the claim is, is in still process or it uh may I know the status of the claim?
[AGENT][NEUTRAL] Is waiting for the primary explanation of benefits to be processed.
[CUSTOMER][NEUTRAL] In this so.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] So you need only primary UB or along with uh UV your home phone?
[AGENT][NEUTRAL] We need just the primary EOB to continue the processing of this claim.
[CUSTOMER][NEUTRAL] OK. So, could you tell me the mailing address?
[AGENT][NEUTRAL] Yes, the address to submit claims or additional information is [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The zip code is [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm. [PII]. Correct, yes.
[CUSTOMER][NEUTRAL] [PII]. Is that right? OK. Could you tell me the fax number?
[AGENT][NEUTRAL] That's [PII].
[CUSTOMER][NEUTRAL] OK. Could you reconfirm that for me, so. It's [PII].
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] OK. Could you tell me the time limit?
[AGENT][NEGATIVE] We don't have time to filing limits.
[CUSTOMER][NEUTRAL] OK. So could you tell me the call this number for this call, please?
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in today's date.
[CUSTOMER][NEUTRAL] OK, just a moment hold.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Just a moment, sir.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][POSITIVE] Uh, thank you for being on hold. So uh hope you have a nice day. Thank you. Bye.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] You as well and thank you for calling APO. Bye-bye, Mr. [PII].