AccountId: 011433970860
ContactId: be0f7864-a863-4006-9bf3-b02cd6943358
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 355869 ms
Total Talk Time (AGENT): 83426 ms
Total Talk Time (CUSTOMER): 110578 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/02/be0f7864-a863-4006-9bf3-b02cd6943358_20250402T19:14_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] I'm looking for a claim information for one of my patients.
[AGENT][NEUTRAL] OK, do you have the, what was your name and a good callback number?
[CUSTOMER][NEUTRAL] My name is [PII] and my callback number is [PII], direct calling number.
[AGENT][NEUTRAL] Do you have the policy number of the patient?
[CUSTOMER][NEUTRAL] 01635430. M as in Mary, L as in Lima, 8.
[AGENT][NEUTRAL] And the patient name and date of birth?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And you need a claim status, is that correct?
[CUSTOMER][NEUTRAL] Yeah, for this one I need claim status.
[AGENT][NEUTRAL] So the date of service.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the bill amount?
[CUSTOMER][NEUTRAL] $60,837.16.
[AGENT][NEUTRAL] And who is the provider?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] You have the provider name?
[CUSTOMER][NEUTRAL] My provider name is West Boca Medical Center.
[AGENT][NEUTRAL] OK, um, give me one moment.
[AGENT][NEUTRAL] Um, it looks like we've denied the claim because we need the explanation of benefits that matches the claim information.
[CUSTOMER][NEUTRAL] Can you please give me the claim number?
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] My number is 351-697-4.
[CUSTOMER][NEUTRAL] That's all?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] So like we submit to.
[CUSTOMER][NEUTRAL] This EOB to the insurance like that EOB is not correct. Do you need like, may I know like what type of like uh UOB you need?
[AGENT][NEUTRAL] So the EOB doesn't match what you submitted the claim for?
[AGENT][NEUTRAL] So they have to match exactly?
[AGENT][NEUTRAL] Let me pull it up.
[CUSTOMER][NEGATIVE] Like you have UV but that is not correct.
[AGENT][NEUTRAL] Like.
[AGENT][NEGATIVE] Yeah, it doesn't match what the claim was submitted for.
[CUSTOMER][NEUTRAL] Like that is from different bill amount or like something different. Can you please tell me so that I can.
[CUSTOMER][NEUTRAL] Tell my billing team.
[AGENT][NEUTRAL] Yes, the billed amount on the EOB that was submitted was for $1,029.
[AGENT][NEUTRAL] But you're submitting a claim for 60,000 plus.
[CUSTOMER][NEUTRAL] OK, like we need to submit the correctly to the insurance.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] Thank you so much for the information. Can you please tell me your name, please?
[AGENT][NEUTRAL] Uh, my name is [PII]. First initial of my last name is [PII], and then today's date with my name would be the reference number. And can I help with anything else today, [PII]?
[CUSTOMER][POSITIVE] Thank you so much, [PII], for the information. And can you please confirm me like where we have to submit that uh UB again?
[AGENT][NEUTRAL] Do you want our mailing address or fax?
[CUSTOMER][NEUTRAL] Like do it
[CUSTOMER][NEUTRAL] Uh, you mean both like mailing address. I have [PII] City OK [PII] if I am correct.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] And give me the fax number also.
[AGENT][NEUTRAL] Fax number is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Thank you so much, [PII], for the information and have a great day. And is it possible that you can fax me that EOB?
[AGENT][NEUTRAL] Sure, what's your fax number?
[CUSTOMER][NEUTRAL] My fax number is [PII].
[AGENT][POSITIVE] OK, I'll get that faxed to you right now.
[CUSTOMER][POSITIVE] Thank you so much. Have a great day. Bye-bye.
[AGENT][POSITIVE] Thank
[AGENT][POSITIVE] OK, thanks for calling APLU as well.