AccountId: 011433970860
ContactId: d4b33ab4-411d-4b15-8a5d-985508aa4985
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 328700 ms
Total Talk Time (AGENT): 98836 ms
Total Talk Time (CUSTOMER): 84392 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/13/d4b33ab4-411d-4b15-8a5d-985508aa4985_20250213T19:55_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. This is [PII] calling from our provider's office, checking up on our medical bill payment status, sorry, claim status.
[AGENT][NEUTRAL] OK, and you said your name is [PII]. Is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes, [PII], and I can help you with claim status. And what is your callback number?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you, [PII]. And how many claims do you have to check status on today?
[CUSTOMER][NEUTRAL] 1
[AGENT][NEUTRAL] OK, and what is that member's policy number, please?
[CUSTOMER][NEUTRAL] 023-359
[CUSTOMER][NEUTRAL] 00
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, actually, that is an 8 instead of a B.
[AGENT][NEUTRAL] It should be a number 8.
[CUSTOMER][NEUTRAL] OK. The policy number is 023.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 35,900.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Thank you. And any information that I provide for you today, [PII] will be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth, please?
[CUSTOMER][NEUTRAL] [PII]. Date of birth is [PII].
[AGENT][POSITIVE] Thank you, one moment.
[CUSTOMER][NEUTRAL] And I have a specific question, and I also have a claim number.
[AGENT][NEUTRAL] OK, one moment please.
[CUSTOMER][NEUTRAL] Mhm. OK.
[AGENT][NEUTRAL] And what is the claim number?
[AGENT][NEUTRAL] And data service.
[CUSTOMER][NEUTRAL] That is
[CUSTOMER][NEUTRAL] Sure, that's um [PII]. The claim number is uh
[CUSTOMER][NEUTRAL] 352-867-0
[AGENT][NEUTRAL] OK, and the total bill amount for that data service, [PII]?
[CUSTOMER][NEUTRAL] $50,833.
[AGENT][NEUTRAL] OK, thank you one moment. OK, one moment please.
[CUSTOMER][NEUTRAL] Even
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and how can I help you with that claim, [PII]?
[CUSTOMER][NEUTRAL] May I know the original of claim received date and process date, please?
[AGENT][NEUTRAL] The claim was received on [PII], denied on [PII].
[CUSTOMER][NEUTRAL] OK. We have received uh the from you stating the new primary UB as I can see from my end, we have already faxed the primary OB which was sent on [PII].
[CUSTOMER][NEUTRAL] Can you check from here and let me know whether have you received that or not?
[AGENT][NEUTRAL] I can see that there is something that was received on the [PII] for this number. I can check to see if that is your EOB, but it has not been reviewed at this time. One moment, please.
[CUSTOMER][NEUTRAL] S
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I I'll be put now I.
[CUSTOMER][NEUTRAL] I always
[AGENT][NEGATIVE] It is still trying to load the information for me.
[CUSTOMER][NEUTRAL] OK. May I know your name?
[AGENT][NEUTRAL] Again, my name is [PII]. My name in today's date will be your call reference number.
[AGENT][NEUTRAL] And [PII], if you need a copy of our explanation of benefits for this claim, you can print that by going to our portal at [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And we, this is the, we did receive.
[AGENT][NEUTRAL] The primary EOB and it is in line for review.
[CUSTOMER][NEUTRAL] May I know how many days it will take to review and reprocess?
[AGENT][NEUTRAL] 7 to 7 to 10 business days.
[CUSTOMER][POSITIVE] OK. Thank you so much. Bye-bye, [PII].
[AGENT][POSITIVE] You are certainly welcome. Yes, ma'am, and thank you for calling APL if that's all I can.