AccountId: 011433970860
ContactId: b780dc73-798e-49a0-979f-374ddb566879
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 305339 ms
Total Talk Time (AGENT): 129893 ms
Total Talk Time (CUSTOMER): 135471 ms
Interruptions: 3
Overall Sentiment: AGENT=0.8, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/16/b780dc73-798e-49a0-979f-374ddb566879_20250516T14:29_UTC.wav
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[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] Thank you for calling APL. This is Ka[PII]How can I help you?
[CUSTOMER][NEUTRAL] I tell you put it around at some point it started this place.
[CUSTOMER][NEUTRAL] Um, yes, I was trying to check eligibility for a patient.
[AGENT][NEUTRAL] Yeah, I can check eligibility for you. um, what was your name please?
[CUSTOMER][NEUTRAL] My name is Ka[PII]ou said the facility? I'm sorry.
[AGENT][NEUTRAL] I'm sorry, no, no, no, yeah, I was just asking your name.
[CUSTOMER][NEUTRAL] Oh, Kw[PII].
[AGENT][POSITIVE] [PII]ot it thank you. Uh, Ke[PII]can I get a good call back number from you in case we're disconnected please?
[CUSTOMER][NEUTRAL] 91[PII]
[AGENT][NEUTRAL] [PII]hank you. And then do you have the policy number?
[CUSTOMER][NEUTRAL] Uh yes, it's 01930255.
[AGENT][NEUTRAL] OK and then what was the name and date of birth for the member please?
[CUSTOMER][NEUTRAL] It's for Gu[PII]oodnight.
[CUSTOMER][NEUTRAL] And Fe[PII].
[AGENT][NEUTRAL] OK, thank you for verifying that. Uh, so this policy I am showing it did terminate, uh, Fe[PII]If you'll give me one moment though, I'll see if they have one that's active. It might just be a different policy number.
[CUSTOMER][NEUTRAL] Well, no, that's good. I'm looking for an older date of service of No[PII]um, and then.
[AGENT][NEUTRAL] Oh,
[AGENT][POSITIVE] OK, perfect. So yeah, that would be.
[CUSTOMER][NEUTRAL] We had
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK, we had sent some claims in and we haven't heard anything back but I'm not able to check the status online because we don't have a claim number um is there another way or?
[AGENT][NEUTRAL] Sure, yes. OK, let's see.
[AGENT][NEUTRAL] No, unfortunately not um our portal is actually currently undergoing some changes so hopefully it'll be easier in the future for providers um in the meantime though, I can go ahead and check that, uh, these claims they were for Gunner.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, um, were they all for the same date of service?
[CUSTOMER][NEUTRAL] Um, so, no, but if, if I check one day of service, it's probably gonna be the same with all.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Sure, I can check that um go ahead with that first date of service.
[CUSTOMER][NEUTRAL] No[PII].
[AGENT][NEUTRAL] OK, one moment. Do you have that uh billed out?
[CUSTOMER][NEUTRAL] $492.35.
[AGENT][NEUTRAL] I'm sorry, it kind of cut out there at the beginning. Could you repeat that?
[CUSTOMER][NEUTRAL] Yeah, 492 35.
[AGENT][POSITIVE] 492. OK, alrighty thank you one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, I'm not showing that we've received any claims uh for Gunner for that date of service. That was No[PII].
[CUSTOMER][NEUTRAL] Yeah, um, we didn't, we mailed them in Ja[PII]so let me just verify the address we have for claims is the PO[PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] That is correct in Ok[PII]yes ma'am. I've also got a fax number and a payer ID if you'd like that.
[CUSTOMER][NEUTRAL] In Ok[PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. Yeah. What's the, I think I have a fax number ending in 94[PII].
[AGENT][NEUTRAL] That's, yes.
[CUSTOMER][NEUTRAL] OK, and you said a payer ID?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, what's that?
[AGENT][NEUTRAL] That is 60801.
[CUSTOMER][NEUTRAL] OK, so you guys accept claims electronically?
[AGENT][NEUTRAL] Yes, absolutely, and uh these policies don't have any timely filing limit.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] So you're OK to resubmit those whenever?
[CUSTOMER][NEUTRAL] OK. And then
[CUSTOMER][NEUTRAL] OK, awesome. And then my last thing was, um, if you accept them electronically, um.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Because I'm trying to figure out like how do you guys obtain the primary insurance EOB.
[CUSTOMER][NEUTRAL] If it's a secondary.
[AGENT][NEUTRAL] Um, are you, are you able to send that information electronically?
[CUSTOMER][NEUTRAL] I don't know. You know, I'm not exa I know we do with uh Medicare. I'm not sure how this is, so I'll probably just try to mail or fax them.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Sure, yeah, whatever is easier for you. I know some providers I know some providers can do that electronically but I don't know you know it depends I guess whatever is easier for y'all.
[CUSTOMER][NEUTRAL] So that I can make sure the EOB is attached.
[CUSTOMER][POSITIVE] OK awesome and what what was your name again?
[AGENT][NEUTRAL] Ka[PII].
[CUSTOMER][NEUTRAL] [PII]K, alright, Ka[PII]thank you so much. I'll go ahead and have these resent in.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Of course. Was there anything else I could help you with, Ka[PII]?
[CUSTOMER][NEUTRAL] Um, no, did you have a reference number or do I just use your name and date?
[AGENT][NEUTRAL] Um, it would be my first name, last initial, and today's date, um, so my last initial is A.
[CUSTOMER][POSITIVE] [PII]K, awesome, thank you.
[AGENT][POSITIVE] Of course, thanks for calling AP[PII]Have a great rest of your day.
[CUSTOMER][NEUTRAL] You too.
[AGENT][POSITIVE] Thanks bye bye.
[CUSTOMER][NEUTRAL] Bye-bye.