AccountId: 011433970860
ContactId: dabb98b9-b40a-4db2-acad-1e409f43f4a2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 330239 ms
Total Talk Time (AGENT): 173540 ms
Total Talk Time (CUSTOMER): 132371 ms
Interruptions: 3
Overall Sentiment: AGENT=2.8, CUSTOMER=1.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/26/dabb98b9-b40a-4db2-acad-1e409f43f4a2_20250326T18:47_UTC.wav
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[AGENT][POSITIVE] Afternoon, thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII]. My name is [PII] and
[CUSTOMER][NEUTRAL] I need to check um.
[CUSTOMER][NEUTRAL] If coverage is still active for a patient of ours, and if it is then I need to check claim status.
[AGENT][POSITIVE] [PII], it would be my pleasure to assist you. What is a good callback number?
[CUSTOMER][NEUTRAL] Please.
[CUSTOMER][NEUTRAL] That would be [PII] and that's a direct line.
[AGENT][NEUTRAL] Thank you and what is the policy number for the patient please ma'am?
[CUSTOMER][NEUTRAL] I have 02476613.
[AGENT][NEUTRAL] 02476613. And the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][POSITIVE] All right, thank you, and I can help you with eligibility and claim status for LA. I am showing that [PII]'s my pleasure. I'm showing that [PII]'s policy is active with the effective date of [PII].
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] And this is a secondary policy to her primary insurance.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, it is.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh, OK, because I've got it in our system as being uh primary.
[AGENT][NEUTRAL] Actually, we are secondary to.
[CUSTOMER][NEUTRAL] Hm.
[AGENT][NEUTRAL] United Healthcare.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alrighty I will have to check on that then um so I'm guessing if you have the claim you're going to deny it because it did not come over with the primary EOB so we don't even have to check.
[AGENT][NEUTRAL] All right. Well, I can check it and then provide a claim number and then once you get that primary EOB all you have to do is fax over the EOB and referencing the policy number and claim number or if you just want to submit a whole new claim either way.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, well I guess we can check then.
[AGENT][NEUTRAL] What's the data service?
[CUSTOMER][NEUTRAL] It is, it is [PII].
[AGENT][NEUTRAL] And that bill amount?
[CUSTOMER][NEUTRAL] $5,009.61.
[AGENT][NEUTRAL] And then the facility name.
[CUSTOMER][NEUTRAL] Saint Vincent's Medical Center.
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] Well,
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] We did receive that claim on [PII] and processed on 35, and you are right, it is pending for that primary EOB.
[CUSTOMER][NEUTRAL] OK, primary you'll be alrighty then, um, so it, uh, was it issued a claim number or signed a claim number?
[AGENT][NEUTRAL] It was, and that claim number is 357.
[AGENT][NEUTRAL] 1539
[CUSTOMER][NEUTRAL] OK, thank you [PII]. Is there a call reference number for our conversation?
[AGENT][NEUTRAL] Call reference my num num my number.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Aren't we having a time today, huh?
[AGENT][NEUTRAL] Monday #3. We only got 2 more Mondays to go.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yep.
[AGENT][NEUTRAL] And if you always think Friday is a Monday, it makes it for a short week.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] This, this is true. This is true. I've never thought of it that way.
[AGENT][NEUTRAL] Oh my goodness. The claim number is 3571539.
[CUSTOMER][POSITIVE] Oh goodness gracious.
[CUSTOMER][NEUTRAL] OK, that's that's the claim number. Is there a call reference number?
[AGENT][NEUTRAL] And that is my name and today's date, and I spell my name, [PII]
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] First initial last name [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And [PII], we also have a provider portal if you're ever interested, you can go to [PII] and sign in as a provider using the tax ID number and the patient's account number listed in the box 3A on the UBO4.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And you can submit that EOB once you have it directly online. You can also have access to EOBs and claim status.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][POSITIVE] Oh, awesome.
[CUSTOMER][POSITIVE] That is awesome. Thank you for that information. I did not know that.
[AGENT][POSITIVE] My pleasure. Yeah, and it's a real easy registration.
[AGENT][NEUTRAL] And just use the patient's account number when it asks for the account number, be sure to use that account number inbox 3A on the UBO4.
[CUSTOMER][NEUTRAL] OK. Well, that's good to know.
[CUSTOMER][NEUTRAL] OK, I will 3 A.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK, we are all set. Enjoy the rest of your Monday, Monday, Monday, and uh.
[AGENT][POSITIVE] I love it.
[AGENT][POSITIVE] Thank you, [PII]. You just made my day.
[CUSTOMER][POSITIVE] Oh, you're welcome.
[AGENT][POSITIVE] We have to have a little bit of fun along the way, don't we?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][POSITIVE] Yes, yes, we do. I totally agree 100%. 0, OK, yes it is.
[AGENT][POSITIVE] Laughter is good for the soul. No, it's good.
[AGENT][POSITIVE] Well, it's been such a pleasure to assist you. Is there anything else I can help you with today?
[CUSTOMER][NEUTRAL] Oh,
[CUSTOMER][POSITIVE] No, that was it. Thank you so much.
[AGENT][POSITIVE] [PII], thank you for calling APL and I hope you have a great afternoon.
[CUSTOMER][POSITIVE] Thank you. Bye bye.
[AGENT][POSITIVE] Thank you. Bye-bye.