AccountId: 011433970860
ContactId: e2522234-d669-4cbd-926c-22caeac882f5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 334760 ms
Total Talk Time (AGENT): 132554 ms
Total Talk Time (CUSTOMER): 102120 ms
Interruptions: 0
Overall Sentiment: AGENT=-0.3, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2024/12/31/e2522234-d669-4cbd-926c-22caeac882f5_20241231T20:11_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from the provider's office to check on a claim status.
[AGENT][NEUTRAL] I can help you, [PII]. What's the policy number?
[CUSTOMER][NEUTRAL] That is 0236.
[AGENT][NEGATIVE] OK, I can barely hear you and you sound very muffled.
[CUSTOMER][NEUTRAL] 383 9.
[CUSTOMER][NEUTRAL] Uh, can you hear me now?
[AGENT][POSITIVE] That's better. Thank you.
[CUSTOMER][NEUTRAL] 02
[CUSTOMER][NEUTRAL] 363 8.
[CUSTOMER][NEUTRAL] 39
[AGENT][NEUTRAL] OK. And what's a good phone?
[CUSTOMER][NEUTRAL] M [PII] Mike. L [PII] Lima, [PII].
[AGENT][NEUTRAL] Mhm, thank you. What's a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII] direct line.
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Yes, one moment.
[CUSTOMER][POSITIVE] Take your time.
[AGENT][NEUTRAL] And verify the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] The business's name is.
[CUSTOMER][NEUTRAL] Melson Jean [PII] and the date of birth is on [PII].
[AGENT][NEUTRAL] OK, thank you for that. And you said that you're checking a claim status, uh, [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, I can help with that. What is the data service and the total charge?
[CUSTOMER][NEUTRAL] Uh, I do have a claim number. If you want me to give the claim number, I can give it.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Claim number is fine.
[CUSTOMER][NEUTRAL] 348-5205
[AGENT][NEUTRAL] 348-5209
[CUSTOMER][NEUTRAL] 205
[AGENT][NEUTRAL] 205. OK, so are you wanting clarification on the processing of this claim?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And specifically, what, what type of clarification?
[CUSTOMER][NEUTRAL] Uh, I have a, uh, correspondence here it is stating like, uh.
[CUSTOMER][NEUTRAL] Uh, just a moment.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Yeah, I have a correspondent here that hello, can you hear me?
[AGENT][NEUTRAL] Uh-huh. Yes, I'm, I, I can hear you.
[CUSTOMER][NEUTRAL] Yeah, I have a correspondence here and it is stating like, uh, claim appears to be duplicate uh so I, I want to know the original claim status of this claim.
[AGENT][NEUTRAL] So under the the claim number that you gave me, it's we're requesting a copy of the primary insurance explanation of benefits under that claim number.
[CUSTOMER][NEUTRAL] And uh
[CUSTOMER][NEUTRAL] We have already sent that.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] We have already sent the primary will be through fax.
[AGENT][NEUTRAL] When did you send it?
[CUSTOMER][NEUTRAL] Uh, the last it will be that we have sent is on [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEGATIVE] And the last documentation received, not necessarily from you was, but uh maybe a different provider was on [PII]. We've not received anything in [PII].
[CUSTOMER][NEUTRAL] OK, how do you want us to send this primary will be?
[AGENT][NEUTRAL] How did you send it before? Did you fax it or did you mail it?
[CUSTOMER][NEUTRAL] Yeah, it's fax and the number is [PII].
[AGENT][NEUTRAL] That is correct and it can be faxed make that to the attention of the claims. Um, I do show that we received it [PII] and it denied as a duplicate duplicate because it was just the itemized bill. The primary ELB was not attached at that time either.
[CUSTOMER][NEUTRAL] Sure, um
[CUSTOMER][NEUTRAL] Uh, OK. Could you please tell me when this claim was received on?
[AGENT][NEUTRAL] The duplicate claim was received [PII], processed [PII] under claim number 352.
[AGENT][NEUTRAL] 8746.
[CUSTOMER][NEUTRAL] OK, and uh
[CUSTOMER][NEUTRAL] Yeah. May I know your name?
[AGENT][NEUTRAL] You'll use my name in today's date as reference for today's call [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] First initial of my last name is [PII].
[AGENT][NEUTRAL] And did you have any other questions we can help out with today?
[CUSTOMER][NEUTRAL] Yeah, I do have one more claim here. I want you to check the claim status of that claim also.
[AGENT][NEUTRAL] OK, and it looks like we received the claim we just talked about several times and denied it as a duplicate twice, so.
[CUSTOMER][NEGATIVE] No, no, no, no, no, I'm not talking about this game. I have another player.
[AGENT][NEGATIVE] I know it, but I wanted to give you that information. You said you submitted it several times. We received it the 1st 3 times, 2 times it denied as a duplicate just for the just for the record and call documentation. Give me just a moment to document this claim and we can proceed, OK?
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] One moment.