AccountId: 011433970860
ContactId: e0d67613-54c2-4839-bff6-26d80388a14c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 503630 ms
Total Talk Time (AGENT): 136464 ms
Total Talk Time (CUSTOMER): 76603 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=-1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/28/e0d67613-54c2-4839-bff6-26d80388a14c_20250228T17:52_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yes, hi, um, I have an explanation of benefits saying that they're not paying anything because they're missing information, but everything that was on the EOB saying was missing was sent in.
[AGENT][NEUTRAL] OK, I can help you with your claim. Um, can I please get your name and your callback number?
[CUSTOMER][NEUTRAL] It's [PII], it's [PII].
[AGENT][NEUTRAL] Thank you, Ms. [PII]. And then what is your policy number?
[CUSTOMER][NEUTRAL] 02478721
[AGENT][NEUTRAL] OK, let me look that up real quick.
[CUSTOMER][NEUTRAL] And your name?
[AGENT][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] OK, and you said your policy number is 02478721?
[CUSTOMER][NEUTRAL] That's not my policy. I'm calling from the provider's office.
[CUSTOMER][NEUTRAL] Has the option for provider.
[AGENT][NEUTRAL] Oh, OK. I'm sorry. I am so sorry. I thought you were the insured. I apologize, Ms. [PII]. OK, and what's the name of the provider's office you're calling from?
[CUSTOMER][NEUTRAL] Millennium Healthcare.
[AGENT][NEUTRAL] OK, and then what is the patient's name and.
[AGENT][NEUTRAL] Birth?
[CUSTOMER][NEUTRAL] The patient's name is [PII]. Date of birth, [PII].
[CUSTOMER][NEUTRAL] Did you want the claim number?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, please.
[CUSTOMER][NEUTRAL] Claim number 3513237.
[AGENT][NEUTRAL] OK, let me look that up real quick.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] There are 2 remarks on this claim. The first one being the insured's primary insurance provided full benefits. There are no benefits payable, and then also,
[AGENT][NEUTRAL] In order to complete the process.
[CUSTOMER][NEUTRAL] That's not
[CUSTOMER][NEUTRAL] They, she sent them the EOB to show that they're responsible for the co-insurance. Medicare doesn't cover anything at 100%.
[CUSTOMER][NEUTRAL] For Part B.
[AGENT][NEUTRAL] OK, so.
[CUSTOMER][NEUTRAL] All the ELBs for
[AGENT][NEUTRAL] Yes, ma'am. I understand. Um, and it's also saying that we needed um the itemized statement with the diagnosis code and procedure codes.
[CUSTOMER][NEUTRAL] She sent you the 1500 forms that had all the information on it.
[AGENT][NEUTRAL] OK, so what I'm gonna do is I'm gonna get a claims examiner to give you a call back so that you guys can go over this claim together.
[AGENT][NEUTRAL] Um
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The number that you gave me, the [PII], is that a good callback number for you?
[CUSTOMER][NEUTRAL] Yes, they can hit [PII] for the operator and then ask for [PII].
[AGENT][NEUTRAL] 0 and then [PII]. OK, I'm gonna put you on a brief hold while I get that um request sent in so you can get a call back and I'll be right back with you.
[CUSTOMER][POSITIVE] OK, thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you Ms. [PII] for holding for me. I've got that request in for somebody to give you a call back and I gave him the instructions to press 0 and then ask for you.
[CUSTOMER][NEUTRAL] OK, what's the reference number?
[AGENT][NEUTRAL] You can use my name. It's [PII], and today's date.
[CUSTOMER][NEUTRAL] When are they gonna call me back?
[AGENT][NEUTRAL] They should give you a call back within 24 hours.
[CUSTOMER][NEUTRAL] Eastern Standard Time because we have a big problem that everybody likes to call back after we're closed at [PII].
[AGENT][NEUTRAL] OK, we're central.
[CUSTOMER][NEUTRAL] OK, we're Eastern.
[AGENT][NEUTRAL] OK, and they will see that you're from [PII] and they should be able to put that into consideration.
[CUSTOMER][NEUTRAL] I'm just letting you know that usually they don't and then they say that we weren't here when.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right. I'm gonna um.
[AGENT][NEUTRAL] Put a
[AGENT][NEUTRAL] Mark on this
[AGENT][NEUTRAL] Request that I sent in and just.
[AGENT][NEUTRAL] Reference that you are Eastern time.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. I've got that remark on there so that.
[AGENT][NEUTRAL] They'll know.
[CUSTOMER][POSITIVE] Thank you very much.
[AGENT][POSITIVE] You're very welcome. I hope you have a wonderful weekend and I thank you for calling APL.
[CUSTOMER][NEUTRAL] Bye.