AccountId: 011433970860
ContactId: d9229349-111d-45f8-aa41-aabcb19d6be1
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 366179 ms
Total Talk Time (AGENT): 116218 ms
Total Talk Time (CUSTOMER): 135719 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/01/d9229349-111d-45f8-aa41-aabcb19d6be1_20250501T15:04_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], um, I'm calling with the provider's office and I need to um see if a claim is on file for the patient.
[AGENT][NEUTRAL] Sure, I could check on a claim for you. Uh, what was your name please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK [PII], can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] Thank you and then do you have that policy number?
[CUSTOMER][NEUTRAL] Yes, uh 02353101.
[AGENT][NEUTRAL] Got it. And what was the name and date of birth for the member, please?
[CUSTOMER][NEUTRAL] Uh [PII], last name is [PII]
[CUSTOMER][NEUTRAL] And her date of birth is [PII].
[AGENT][POSITIVE] Perfect, thank you for verifying that uh what was the date of service for this claim?
[CUSTOMER][NEUTRAL] Um, the data service was for, hold on one second.
[CUSTOMER][NEUTRAL] OK, well, it starts on [PII]. My computer froze, um, hold on.
[AGENT][NEUTRAL] That's OK.
[AGENT][NEUTRAL] Um, that's all right, um, so it was multiple dates?
[CUSTOMER][NEUTRAL] Um, it's OK.
[CUSTOMER][NEUTRAL] Um, I, I don't, there could be a date span because we do home infusion, um, but it the beginning date is [PII], and it was for $5,532.59.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, uh, now was that amount before or after major medical paid, [PII]?
[CUSTOMER][NEUTRAL] Uh, that was before.
[AGENT][NEUTRAL] OK, do you have that remaining balance after?
[CUSTOMER][NEUTRAL] Uh, yes, uh, remaining balance after was $662.67.
[AGENT][NEUTRAL] OK and then do you have the uh tax ID for this provider?
[CUSTOMER][NEUTRAL] Uh, yes, it's um hold on one second.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, let's see. OK, there it goes now it decides to work. Uh, hold on.
[CUSTOMER][NEUTRAL] Jesus, I swear technology. Um, yes, it's Option Care Enterprises and the tax ID number is um [PII].
[AGENT][POSITIVE] OK awesome thank you one moment please.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Bear with me just a moment. I'm thinking about it.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so I did find this claim.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] That we were unable to pay a benefit as it states based off of the information that was included in the claim form, the services were not rendered in a covered place of service for this policy.
[CUSTOMER][NEUTRAL] So it's not rendered in a cover in a covered.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] Facility.
[CUSTOMER][NEUTRAL] By a covered provider of facility.
[AGENT][NEUTRAL] By covered facility, yes, this one isn't um it's not a part of a network as it's a secondary medical policy, but it can be particular on where services are rendered and if you'd like I can send you this uh EOB if you need that.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, that, that would be good. Um, OK. Are you putting it to the patient's responsibility or no?
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Um, we don't say what is patient responsibility. That would be up to the provider.
[CUSTOMER][NEUTRAL] OK, so it's not, it's not, OK, so not rendered in a covered in a um by a covered facility. OK. Do you have a claim number?
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] Yes, that is 356-693-9.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, 939. OK, and what was your name?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII] and then did you have a fax number I could send this to?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, yes, um, yeah, the fax number you can send it to is 504.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, I'm gonna read that back to make sure I heard that correctly. That was [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Alright, I will go ahead and send that now. Should get it within about 10 minutes or so. Was there anything else I could help you with?
[CUSTOMER][NEUTRAL] OK, if you could just, yeah, if you could just put [PII] on it so they know.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] See, yeah, I'll put that uh attention.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and uh could I get a call reference number?
[AGENT][NEUTRAL] Sure, that would just be my first name, last initial, and today's date and for my last initial is A.
[CUSTOMER][NEUTRAL] OK, so A and then 50125. OK, all right, thank you.
[AGENT][POSITIVE] Of course, thanks for calling APL hope you have a great rest of your day.