AccountId: 011433970860
ContactId: d7bd908e-38b2-4eab-ab3e-63d20a6e6bad
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 235899 ms
Total Talk Time (AGENT): 87782 ms
Total Talk Time (CUSTOMER): 94079 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/28/d7bd908e-38b2-4eab-ab3e-63d20a6e6bad_20250228T13:54_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII] and I am with the provider's office and I need to check on the status of the claim. It looks like we sent you guys a bill, but we have not heard anything back on it.
[AGENT][NEUTRAL] OK, I can help you, [PII]. um, what is the policy number and a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] Policy number is showing as 17237.
[AGENT][NEUTRAL] Mm that's the group number?
[CUSTOMER][NEUTRAL] And then my phone num
[AGENT][NEUTRAL] Go down a little further.
[CUSTOMER][NEUTRAL] OK, let me pull up.
[AGENT][NEUTRAL] Yeah, I think it's
[CUSTOMER][NEUTRAL] Yeah, let me pull the card up itself.
[AGENT][NEUTRAL] Uh, OK, OK. Should be an outpatient inpatient certification number, maybe near the bottom of the card.
[CUSTOMER][NEUTRAL] Here it is. OK, hold on a second, that might be why you guys didn't get it. Hold on.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, this is outpatient, so it would be 01887382.
[AGENT][NEUTRAL] OK. That's
[CUSTOMER][NEUTRAL] M like Mary, L like Lisa, 8.
[AGENT][NEUTRAL] OK, and the inpatient should be the same number before the letter um.
[AGENT][NEUTRAL] The ailment after is kind of internal for us, so, OK, and so I'm sorry, go ahead and give me your phone number.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK number is um.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. Let me pull up the policy, verify the patient, and then we can provide the status.
[CUSTOMER][POSITIVE] Sounds good.
[AGENT][NEUTRAL] And what is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Um, [PII]. Date of birth is.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you for that [PII] and what's the date of service?
[CUSTOMER][NEUTRAL] Um, date of service is [PII].
[AGENT][NEUTRAL] And the bill amount?
[CUSTOMER][NEUTRAL] The total amount billed on this is.
[CUSTOMER][NEUTRAL] $1,542.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And can you verify how the claim was submitted electronically or by mail?
[CUSTOMER][NEUTRAL] Let me check.
[CUSTOMER][NEUTRAL] It looks like it may have been e-billed, but I can't see the payer ID that they used.
[AGENT][NEUTRAL] Because I'm not showing it on file and did you say the patient was [PII]?
[CUSTOMER][NEUTRAL] Yeah, um, we used that first number, the group number when we build so that may be what the problem is.
[AGENT][NEUTRAL] Yeah, I'm not
[AGENT][NEUTRAL] OK, the group, yeah, that's the group number I believe, the employer group number.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah it is so that may be what the problem is um.
[AGENT][NEUTRAL] Hm
[AGENT][NEUTRAL] Yeah, and if you. Mhm.
[CUSTOMER][NEUTRAL] So.
[AGENT][NEUTRAL] You can fax it if you'd like.
[CUSTOMER][NEUTRAL] Let me get a
[CUSTOMER][NEUTRAL] Oh, that'd be good. What's the fax number?
[AGENT][NEUTRAL] Uh, it's [PII].
[AGENT][NEUTRAL] 365.
[AGENT][NEUTRAL] 942-3 attention claims.
[CUSTOMER][POSITIVE] Alrighty perfect I'll go ahead and do that then and do you guys use call reference numbers or no?
[AGENT][NEUTRAL] Um, not a reference number per se, but you can use my name in today's date as your reference if you would like. [PII].
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] Uh, OYA and then first initial last name is [PII]. And did you have any other questions, [PII]?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][POSITIVE] That should do it. I hope you have a great day. Enjoy your weekend.
[AGENT][POSITIVE] You, you too, [PII], thanks for calling APL. Have a good day as well.
[CUSTOMER][NEUTRAL] Mhm. Bye-bye.