AccountId: 011433970860
ContactId: b7cb3aa9-6fad-4aeb-8c16-9b9b125359ec
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 498899 ms
Total Talk Time (AGENT): 179710 ms
Total Talk Time (CUSTOMER): 136448 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/04/b7cb3aa9-6fad-4aeb-8c16-9b9b125359ec_20250204T18:12_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], I need to check an eligibility for a patient that came in.
[AGENT][NEUTRAL] OK, absolutely. What is the patient's policy number?
[CUSTOMER][NEUTRAL] It is 01.
[CUSTOMER][NEUTRAL] 87411117
[AGENT][POSITIVE] Thank you so much. Let me pull that up. And then if you don't mind, can I grab your first name?
[CUSTOMER][NEUTRAL] Yes, my name is [PII].
[AGENT][POSITIVE] Thank you, [PII].
[AGENT][NEUTRAL] And patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII] and date of birth is [PII].
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] So it looks like the patient does have an active plan. It is a different policy number. Do you need to take that down, [PII]?
[CUSTOMER][POSITIVE] Yes, I do that way we can make sure that we get it sent to y'all and it gets paid correctly.
[AGENT][NEUTRAL] OK, great. So the active policy is gonna be 02579327.
[AGENT][NEUTRAL] And the effective date on this is [PII].
[CUSTOMER][NEUTRAL] OK, and is that for, let's see, is that still good for um last year too of [PII] or [PII]?
[AGENT][NEUTRAL] Uh, let's see, 11:15 of 24.
[AGENT][NEUTRAL] Um, so the other policy number that you have that 187 you would use for any claims in 2024, this new one I gave you is gonna be starting in January of this year.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK. OK. And um
[CUSTOMER][NEUTRAL] Is there any way you can look to see if.
[CUSTOMER][NEUTRAL] Um, a claim has gotten to y'all?
[AGENT][NEUTRAL] Yeah, absolutely, for 2024.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] Yeah, absolutely, let's take a look, um.
[AGENT][NEUTRAL] What is the uh data service? It's for Packer, correct?
[CUSTOMER][NEUTRAL] Correct, it's 11:15 of 2024.
[AGENT][NEUTRAL] OK, and then what is the bill amount [PII]?
[CUSTOMER][NEUTRAL] $3,315.
[AGENT][NEUTRAL] OK, let's see.
[AGENT][NEUTRAL] Do you have an amount perhaps after primary?
[CUSTOMER][POSITIVE] Yes, I can pull that up.
[CUSTOMER][NEUTRAL] So after primary it looks like it should be $1,349.25.
[AGENT][NEUTRAL] OK, let me see if I can find something that matches.
[AGENT][NEUTRAL] I'll build them out here.
[AGENT][NEUTRAL] Yeah I'm not showing any claims on file for those billed amounts, can we have some claims for that date of service, but I'm not showing either of those billed amounts.
[CUSTOMER][NEUTRAL] Mm, OK.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] Do you have a claim, yeah, I'm guessing you don't have a claim number or anything.
[CUSTOMER][NEUTRAL] The only claim number that I think that you might be able to find anything is the claim number that we send it with.
[CUSTOMER][NEUTRAL] Um, and I'm not sure.
[CUSTOMER][NEUTRAL] If it'll show it on your end or not, I mean it should, but I mean if you can look the um 15.
[CUSTOMER][NEUTRAL] 20824.
[CUSTOMER][NEUTRAL] X 001 CB
[AGENT][NEUTRAL] Let me see.
[CUSTOMER][NEGATIVE] And this was just, I mean this was mailed out with like the [PII], so I mean it should have already gotten to y'all.
[AGENT][NEUTRAL] OK, let's see here.
[AGENT][NEUTRAL] I believe it's this one right here. Let me double check one.
[CUSTOMER][NEUTRAL] And what it is is a CT scan of the body.
[AGENT][NEUTRAL] It's this other one. OK, let's see.
[AGENT][NEUTRAL] OK. CT scan of body, I see that.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So it looks like we did receive a claim [PII].
[AGENT][NEUTRAL] And it looks like we um paid a benefit payment of 3,149 and 25 cents and this was sent to Heart of the Rockies Regional and that was processed on the [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Do you have a check number by chance?
[AGENT][NEUTRAL] Absolutely. It's gonna be 202-5057 and it's a single check.
[CUSTOMER][NEUTRAL] OK, say that one more time.
[AGENT][NEUTRAL] Sorry, um, it's uh 2202.
[CUSTOMER][NEUTRAL] So.
[AGENT][NEUTRAL] 5057.
[CUSTOMER][NEUTRAL] OK perfect thank you. I had this 5 and 7 mixed up. I was like, I don't think I that so OK.
[AGENT][POSITIVE] No worries.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][POSITIVE] They did pay process one OK 2025. I will see if I can find that payment. Great, thank you.
[AGENT][POSITIVE] You're very welcome, [PII]. Anything else I can do for you?
[CUSTOMER][NEUTRAL] No, um, do you mind, is there any way that you can fax me, um, because I do not have a remit.
[CUSTOMER][NEUTRAL] And my um er bridge, is there any way that you can fax that to me?
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] Absolutely. What's a good fax number?
[CUSTOMER][NEUTRAL] 719-530.
[CUSTOMER][NEUTRAL] 223 5.
[AGENT][NEUTRAL] Right, and [PII], did you say the prefix is 219? The phone kind of cut out.
[CUSTOMER][NEGATIVE] Oh no sorry, 719.
[AGENT][NEUTRAL] 719. OK, so I have [PII] is that correct?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] That is correct.
[AGENT][NEUTRAL] Alright, so I'm sending that over to you now, should be there in about 5 minutes, OK?
[CUSTOMER][POSITIVE] Perfect, thank you.
[AGENT][POSITIVE] You're welcome. Have a good day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye bye.
[CUSTOMER][NEUTRAL] OK.