AccountId: 011433970860
ContactId: b91b3ff2-26d3-4357-8943-f4e61b66d8e0
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 246229 ms
Total Talk Time (AGENT): 88950 ms
Total Talk Time (CUSTOMER): 82505 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/17/b91b3ff2-26d3-4357-8943-f4e61b66d8e0_20250417T16:20_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Um, hi, [PII], this is [PII] calling from the provider's office to check on a claim status.
[AGENT][NEUTRAL] OK, I can check on a claim for you. Uh, [PII], can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure, it's [PII]. And it's a direct line?
[AGENT][NEUTRAL] Thank you. And then do you have that policy number?
[CUSTOMER][NEUTRAL] Yes, it is.
[CUSTOMER][NEUTRAL] 02556230
[AGENT][NEUTRAL] OK, and then what was the name and date of birth uh for the uh patient, please?
[CUSTOMER][NEUTRAL] So the patient name is [PII]. Date of birth of [PII].
[AGENT][POSITIVE] Perfect, thank you for verifying that [PII]. Uh what was the date of service for this claim, please?
[CUSTOMER][NEUTRAL] This is for [PII].
[CUSTOMER][NEUTRAL] And the amount is $551 even.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Got it thank you one moment please.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK, so [PII], we did receive this claim, uh, however, it looks like we're missing a copy of the primary EOB.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So, uh, upon checking on our end, I found that the claim has been, uh, billed along with the primary UB of UHC. So you didn't receive the primary UB?
[AGENT][NEUTRAL] Correct, we did not receive that primary EOB um, whatever information we received was not sufficient, so the EOB does have to include, uh, amounts paid to co-pay, deductible or co-insurance, uh, from the primary insurers.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, uh, I'm sorry. Uh, may I know the claim received it and the denied it?
[AGENT][NEUTRAL] Of course, uh, so that claim was received [PII], and it was processed [PII].
[CUSTOMER][NEUTRAL] May I have the claim number?
[AGENT][NEUTRAL] That is 3583803.
[CUSTOMER][NEUTRAL] So may I know the um address to submit the uh primary UOB or is there any fax number?
[AGENT][POSITIVE] Absolutely, yes. So I do have a mailing address and a fax number. I can give you both if you'd like.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] and a fax number I can. Mm, may I know the fax number?
[AGENT][NEUTRAL] Fax number is [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] That's [PII], right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] And is there any um family filing limit to submit primary EOB?
[AGENT][NEGATIVE] There is no timely filing limit.
[CUSTOMER][POSITIVE] So then that's for to take care. Thank you so much for assisting me and may I know the reference number for conversation.
[AGENT][NEUTRAL] Sure, reference number would just be my first name, last initial, and today's date. Uh so my name is spelled [PII] Last [PII] Was there anything else I could help you with, [PII]?
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] My name is
[CUSTOMER][NEUTRAL] [PII] is [PII]
[CUSTOMER][POSITIVE] Mm that's thank you so much. You may have a wonderful day. Take care bye bye.
[AGENT][POSITIVE] Alright, thanks for calling APL you too bye bye.
[CUSTOMER][NEUTRAL] bye bye.