AccountId: 011433970860
ContactId: e03383c3-649c-4c57-b9d9-96fabda0a75c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 280079 ms
Total Talk Time (AGENT): 110869 ms
Total Talk Time (CUSTOMER): 124481 ms
Interruptions: 1
Overall Sentiment: AGENT=1.1, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/26/e03383c3-649c-4c57-b9d9-96fabda0a75c_20250626T12:58_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], good morning. My name is [PII]. I'm calling from Tishmingo Health Services. I need your help if you don't mind. I'm trying to verify claim status for one of my patients.
[AGENT][NEUTRAL] OK. Well, I can help you with the claim status, and [PII], may I have a good contact number in case we're disconnected and the policy number?
[CUSTOMER][NEUTRAL] Uh huh, sure thing. My direct line is [PII]. Uh, my patient's policy ID is 02583247 for [PII].
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEUTRAL] Mhm sure.
[AGENT][NEUTRAL] And can you verify her date of birth?
[CUSTOMER][NEUTRAL] Uh, sure, her date of birth I have is [PII].
[AGENT][NEUTRAL] Thank you for that. And may I have the date of service and the total bills?
[CUSTOMER][NEUTRAL] Uh huh sure. date of service [PII]. Uh, total bill amount is $197.
[AGENT][NEUTRAL] Thank you and again, all the information provided is a verification of benefits, not a guarantee of payment. Hold on one moment while I locate your claim for you.
[CUSTOMER][POSITIVE] Mhm sure thank you so much I appreciate you.
[AGENT][POSITIVE] You're welcome. You're very welcome.
[AGENT][NEUTRAL] 812.
[AGENT][NEUTRAL] And can you verify the name of the provider's office on the claim?
[CUSTOMER][NEUTRAL] Uh, yes, it is Tishomingo Health Services.
[AGENT][NEUTRAL] Alright, so I'm showing we received the claim on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The claim number is 360.
[AGENT][NEUTRAL] 8412.
[AGENT][NEUTRAL] And on [PII], um, the claim was denied requesting the explanation of benefits from primary insurance.
[CUSTOMER][NEUTRAL] OK, OK, excellent. EOP primary, uh, can this information be faxed to you guys?
[AGENT][POSITIVE] Yes, I can give you our fax number.
[CUSTOMER][POSITIVE] OK, I, I am ready.
[AGENT][NEUTRAL] Alright, so it's [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII] my apologies, uh huh.
[AGENT][NEUTRAL] And that's a
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Are you OK? No, no, go ahead.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Yes, that's correct. And it's attention.
[CUSTOMER][NEUTRAL] OK, uh, anyone's attention, mhm.
[AGENT][NEUTRAL] Mhm. APL claims department.
[CUSTOMER][NEUTRAL] APL claims department.
[CUSTOMER][NEUTRAL] OK, uh, do you guys need the UBO4 as well or just the primary EOB?
[AGENT][NEUTRAL] Um, you can send the itemized billing.
[AGENT][NEUTRAL] Well, just in case, but all they're requesting is the um
[AGENT][NEUTRAL] I'm sorry, I just went blank. Is the explanation of benefits from primary?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, OK, uh, [PII], I appreciate you thank you so much. Um, two more questions if you don't mind, is there a provider portal that I can get access to or request access to for any of our other patients, uh, maybe to check claim statuses and if there's anything that's needed, and also, may I have a call reference number for the patients chart as well, please?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] All right, so there's no call reference number, but you can use my name in today's date. So that's [PII], first initial to my last name is [PII] and today's date. And then we do have the online service center. Um, you would go to our website, [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So [PII]. And when that page pops up, you'll go to the top right where you see sign in.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] You're gonna create an OSC account as a provider.
[CUSTOMER][POSITIVE] OK perfect thank you so much I appreciate you. I'll also get that you'll be out uh within the hour. Thanks again for your help today.
[AGENT][POSITIVE] You're very welcome. Was there anything else I can assist you with today?
[CUSTOMER][POSITIVE] Uh, no, that'll be all. I appreciate you. Hope you have a great morning.
[AGENT][POSITIVE] You also, thanks for calling APL. Bye-bye.
[CUSTOMER][NEUTRAL] Mhm bye.