AccountId: 011433970860
ContactId: c222aaf6-e5c8-4b69-8674-e6d341a3ff65
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 353329 ms
Total Talk Time (AGENT): 113278 ms
Total Talk Time (CUSTOMER): 114481 ms
Interruptions: 2
Overall Sentiment: AGENT=0.8, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/13/c222aaf6-e5c8-4b69-8674-e6d341a3ff65_20250513T14:34_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII], last name initial [PII], and I'm calling from Memorial Hospital West to check the status on the patient.
[AGENT][NEUTRAL] OK, well, I can help you with the claim status. And [PII], may I have a good contact number in case we're disconnected and the policy number?
[CUSTOMER][NEUTRAL] And [PII] and it's direct. The policy number is 024733777.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] [PII] I'm sorry, [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And may I have the date of service in the claim, um, the date of service and the total bill for the claim, sorry.
[CUSTOMER][NEUTRAL] Yeah, I have 5 claims. The first one is [PII] for $690.
[AGENT][NEUTRAL] Are they all the same patient?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, you can give them all to me.
[CUSTOMER][NEUTRAL] So physical therapy. OK, [PII], [PII], [PII], and each date is for $690.
[AGENT][NEUTRAL] Hold on, hold on.
[AGENT][NEUTRAL] OK, so [PII], and [PII]?
[CUSTOMER][NEUTRAL] OK, it's [PII].
[AGENT][NEUTRAL] Is that correct? I have those. Mhm.
[CUSTOMER][NEUTRAL] [PII], OK. [PII], and the [PII].
[AGENT][NEUTRAL] All 690.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Alright, thank you. Hold on one moment.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] You're welcome. And do you mind if I place you on just a brief hold while I go through the claims?
[CUSTOMER][POSITIVE] Sure, sure, thank you.
[AGENT][NEUTRAL] Alright, hold on one moment. You're welcome.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Um
[AGENT][NEUTRAL] 62.
[AGENT][NEUTRAL] Yeah
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK, so then we need to see what that means. Let me go here.
[AGENT][NEUTRAL] T L I do so.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Hello, [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Alright, thank you so much for holding. I apologize for that wait. So all of the claims, um,
[CUSTOMER][NEUTRAL] It's OK.
[AGENT][NEUTRAL] were denied for the same reason, and then we received the duplicates, but they were all denied as duplicates. Do you want me to go through each day with the claim number? Do you need the date received and processed?
[CUSTOMER][POSITIVE] Good
[CUSTOMER][NEUTRAL] OK, OK, the duplicate should have the primary EOB, which is what you were waiting for.
[AGENT][NEUTRAL] Right, but it doesn't. So that's why I was denied as a duplicate, but I
[CUSTOMER][NEUTRAL] It doesn't?
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] I mean, I can look through them again. I don't mind.
[CUSTOMER][NEGATIVE] Unbelievable.
[CUSTOMER][NEUTRAL] It's OK. Alright, uh, is there a fax number that I could send you these claims?
[AGENT][NEUTRAL] Yeah, um, mhm, so our fax number is [PII].
[CUSTOMER][NEUTRAL] The way the EOB?
[AGENT][NEUTRAL] 365.
[AGENT][NEUTRAL] 942 3.
[CUSTOMER][NEUTRAL] OK, and the original claim number uh for these claims, I think it's 357-8213 for [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 357-821-04 the [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 357-8211 for the [PII], 3578212 for the [PII], and 357-8214 for the [PII], is that correct?
[AGENT][POSITIVE] Yes, that's correct. Mhm.
[CUSTOMER][NEUTRAL] OK, I'll be faxing you the primary UOB. Can I get a phone reference number?
[AGENT][NEUTRAL] Sure, so there's no call reference number, but you can use my name in today's date. The first initial to my last name is [PII].
[CUSTOMER][POSITIVE] OK, thank you so very much. You have a great day bye bye.
[AGENT][POSITIVE] You're welcome. Was there anything else I can help with?
[AGENT][POSITIVE] Thanks for calling APL. Bye-bye.
[CUSTOMER][POSITIVE] That's it thank you bye bye.