AccountId: 011433970860
ContactId: c8135325-75a5-4ba5-931d-9f5a017b912a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 614859 ms
Total Talk Time (AGENT): 226725 ms
Total Talk Time (CUSTOMER): 203509 ms
Interruptions: 4
Overall Sentiment: AGENT=0.4, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/10/c8135325-75a5-4ba5-931d-9f5a017b912a_20250110T17:55_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, so, um, calling to see if a fax was received for a secondary plan.
[AGENT][NEUTRAL] OK, um, sure, I can assist you with claims and you're calling from provider's office or this is your personal policy?
[CUSTOMER][NEUTRAL] Providers.
[AGENT][NEUTRAL] OK, thank you. And may I have your name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you. May I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII] is that right?
[AGENT][NEUTRAL] Thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Yes, I.
[CUSTOMER][NEUTRAL] 02455568
[AGENT][NEUTRAL] Thank you. May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] [PII], date of birth.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, perfect. Thank you. And what is the date of service for that claim?
[CUSTOMER][NEUTRAL] Uh, the first day I'm looking for, um, [PII].
[CUSTOMER][NEUTRAL] So [PII].
[AGENT][NEUTRAL] And what day they were faxed to us?
[CUSTOMER][NEUTRAL] On the [PII].
[AGENT][NEUTRAL] OK, so we received 14 submissions for the [PII].
[AGENT][NEUTRAL] In January, um, how, how many claims did you send in?
[CUSTOMER][NEUTRAL] OK. That's it.
[CUSTOMER][NEUTRAL] I sent two separate facts because one I had sent like over a month ago you guys never received it so I just.
[CUSTOMER][NEUTRAL] We downloaded it and sent it again then I sent the second pack, so did you send, did you receive two possibly?
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] That day, the amount of claims, I don't know. I have, let me see.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] One moment, I can check it right here.
[AGENT][NEUTRAL] Yeah, I'll have to pull each image in order for me to find out which one, so I will have to pull them all. So bear with me just a second.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] It's on here says 17. I can count that's 12.
[CUSTOMER][NEUTRAL] 3
[CUSTOMER][POSITIVE] Wow
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] 11
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] That one has 12 and the other one that might be right. Hold on 12 OK.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] 1314 1
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] 1.
[CUSTOMER][NEUTRAL] Yes, OK.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] 14.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] should be 1820.
[AGENT][NEUTRAL] Yeah, I counted 14.
[AGENT][NEUTRAL] Um
[AGENT][NEUTRAL] You said uh I'm just gonna pull it one by one and give you the ones that I have here, OK, um, so I do see the one for [PII] for [PII]. That one is in line process now, um, I don't see the EOB attached to it, um.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Don't you see that one?
[CUSTOMER][NEGATIVE] You don't do it.
[AGENT][NEUTRAL] Did you send the explanation of benefits?
[CUSTOMER][NEUTRAL] Yes, hold on.
[CUSTOMER][NEUTRAL] One moment here it's fixing.
[CUSTOMER][NEUTRAL] They were received
[CUSTOMER][NEUTRAL] Backwards, like the highest one was for.
[CUSTOMER][NEUTRAL] We're gonna see.
[CUSTOMER][NEUTRAL] I'm going now.
[CUSTOMER][NEUTRAL] 8.6.
[CUSTOMER][NEUTRAL] Yeah, all of them were supposed to have the with it.
[AGENT][NEUTRAL] OK, so that first one I did not see an attachment to it. Let me see if it's submitted again. Let me have one and um.
[CUSTOMER][NEUTRAL] I think
[CUSTOMER][NEUTRAL] Yeah, yeah.
[CUSTOMER][NEUTRAL] It's there.
[CUSTOMER][NEUTRAL] It's there.
[AGENT][NEUTRAL] I'm looking at the images, so I'm just going by what I see once once I pull the image.
[AGENT][NEUTRAL] So that one didn't have the it'll be attached. um, the next one that I have um received was for [PII], which is 2400. That one does have the you'll be attached to it.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so let me go ahead and pull the next one in line.
[AGENT][NEUTRAL] OK. Um, the 3rd image I got here is for.
[AGENT][NEUTRAL] OK, this one is from [PII] for $1740. And this one does have, um,
[AGENT][NEUTRAL] That you'll be attached to it.
[AGENT][NEUTRAL] OK, um, let me see what's the next one.
[AGENT][NEUTRAL] 19251.
[AGENT][NEUTRAL] All right. The next one is for [PII], 1600. This one does have the you'll be attached.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Next one is.
[CUSTOMER][NEGATIVE] Honestly, I didn't even send.
[CUSTOMER][NEUTRAL] One for [PII]. I didn't send one for [PII].
[CUSTOMER][NEUTRAL] I sent one from [PII] [PII]. That was the only one from [PII] that I sent.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] That was the one I just mentioned, the 1600.
[CUSTOMER][NEUTRAL] Yeah, yeah, the one with the 10:15, the 1018, and [PII] and 1025, that, that's not one that I sent.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I mean you guys can have it on file already previously from before, but what I just sent two days ago I didn't send it.
[AGENT][NEUTRAL] Mm, I'm just going by for what I see because again, we received 14.
[CUSTOMER][NEUTRAL] That's what I imagine if you
[AGENT][NEUTRAL] Submissions on that day, a little bit more than 14.
[CUSTOMER][NEUTRAL] I don't see how because it's weird because one fax alone had 12 claims and the other had 6. So I don't know how you received 14.
[AGENT][NEUTRAL] It's, it's a little bit more because she's working on some right now, so there's 23 that are being worked on right now and it's the same date. Um, it was many, many, many claims, um, and I'm just going over the images that I see, um, and giving you the information. Um, I'm not, I'm not a processor and, and it's gonna have to, you know, it goes 7 to 10 business days for it to process even though she's working on some right now, um, but that is the processing time. Yeah, that's the turnaround time.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, and, uh, yeah, but it looks like, yeah, it was about, um, I would say 1314, uh.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] 1516, 17.
[CUSTOMER][NEUTRAL] And when you say submissions, you mean claim, in other words, OK.
[AGENT][NEUTRAL] Yeah, mhm, yeah.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] So it looks like it was like around 18 submissions or claims that we received, yeah.
[CUSTOMER][NEUTRAL] 1, OK, we don't have, we don't have to go through as long as you receive the fax. I'm sure they'll be there. We'll wait on things to process, and then if something does not process, we'll just resend, we'll resend those single ones out that was stuffed out.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right, but yeah, we did receive them and they're in line to be processed, OK?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] OK. Thank you for your help today.
[AGENT][POSITIVE] You're welcome. Is there anything else I'm gonna help you with today?
[CUSTOMER][POSITIVE] No, that'll be all. Enjoy the rest of your day.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] You as well. Thank you for calling APL. bye-bye.
[CUSTOMER][NEUTRAL] Bye.