AccountId: 011433970860
ContactId: c1a99310-7870-40ae-af63-8ef551229a5f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 396480 ms
Total Talk Time (AGENT): 144773 ms
Total Talk Time (CUSTOMER): 110243 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/09/c1a99310-7870-40ae-af63-8ef551229a5f_20250409T21:26_UTC.wav
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[AGENT][POSITIVE] Afternoon, thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling on product offers to check on the gender status.
[AGENT][NEUTRAL] OK, sure. I can assist you with claim status, Miss [PII]. May I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, sure. It's [PII]. You see that direct line, we don't have an extension.
[AGENT][NEUTRAL] OK, thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Yeah, sure. Uh, the patient policy number is 2017678L7.
[AGENT][POSITIVE] Thank you, thank you.
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Mhm. Uh, it's [PII]. The date of birth is [PII].
[AGENT][NEUTRAL] Um, I called, um, can you repeat that policy number?
[CUSTOMER][NEUTRAL] It's 021746.
[CUSTOMER][NEUTRAL] 78 ML 7.
[AGENT][NEUTRAL] Mm OK. And let's see.
[AGENT][NEUTRAL] May I have the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] It's uh [PII], and the bill amount for this claim is $32,479.84.
[AGENT][NEUTRAL] OK, let me see if I can find this claim for you, and that was [PII], correct?
[AGENT][NEUTRAL] OK, for future, you can check claim status online through our website at [PII] and that's just optional.
[AGENT][NEUTRAL] And let's see.
[AGENT][NEUTRAL] Let me check this claim, one moment. Just a minute, OK?
[AGENT][NEUTRAL] OK, I don't have that claim on file.
[AGENT][NEUTRAL] Ms. [PII].
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Gentlemen.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Can you please give me some time? I need some information.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, uh.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Q
[CUSTOMER][NEUTRAL] Uh, may I add the pay ID for this?
[AGENT][NEUTRAL] The payer ID is 60801. Now, this is one of our secondary supplemental plans in the major medical. So the claim needs to be either faxed or mailed because we need a copy of the explanation of benefits from the primary insurance attached to it.
[CUSTOMER][NEUTRAL] So we need to, uh, there is no claim on file. So we need to attach the uh primary EOB, am I right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Yeah, is it OK to send it uh along with the claim?
[AGENT][NEUTRAL] Um, we just need the claim submission and the EOB submission. We don't have the claim at all.
[AGENT][NEUTRAL] So we need the original claim and the EOB from the primary insurance.
[CUSTOMER][NEUTRAL] Not a problem. Um, may I have the
[CUSTOMER][NEUTRAL] Group name and group number?
[AGENT][NEUTRAL] OK. One moment, let me get that for you.
[AGENT][NEUTRAL] OK, the group name is
[AGENT][NEUTRAL] Oushobi SNF Operations LLC.
[CUSTOMER][NEUTRAL] Mhm. May I have the group number?
[AGENT][NEUTRAL] And the group number is 25368.
[CUSTOMER][NEUTRAL] Mhm, uh, may I have the plan for this?
[AGENT][NEUTRAL] This is a secondary supplemental plan to the major medical, secondary policy to the major medical.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] May I have the effective date?
[AGENT][NEUTRAL] Yeah, sure. One moment.
[AGENT][NEUTRAL] The effective date is [PII].
[AGENT][NEUTRAL] It is active at the moment.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] May I have the time is?
[AGENT][NEUTRAL] We don't have time following limits.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, yeah, yes. Uh, just to confirm it, sorry for asking it again. You stated that there is no claim on file, so we need to resubmit to the primary UB Ami right?
[AGENT][POSITIVE] correct.
[CUSTOMER][NEUTRAL] Thank you. May I have the fax or mailing address to send the primary EUB?
[AGENT][NEUTRAL] OK, we need the claim and the EOB, but the address is [PII].
[AGENT][NEUTRAL] 248.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 950.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The zip code is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Thank you. May I have the call reference number for this?
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in today's state if you will.
[CUSTOMER][POSITIVE] Mhm thank you and thank you for your assistance. Have a great day.
[AGENT][NEUTRAL] Uh
[AGENT][POSITIVE] You as well, and thank you for calling APL. Have a good afternoon, Ms. [PII]. Bye-bye.
[CUSTOMER][NEUTRAL] Mhm bye.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] Bye.