AccountId: 011433970860
ContactId: e2db25f4-5c9c-43c4-80d5-5aecaa296a35
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 315579 ms
Total Talk Time (AGENT): 102156 ms
Total Talk Time (CUSTOMER): 88777 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/09/e2db25f4-5c9c-43c4-80d5-5aecaa296a35_20250109T15:16_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh hello, my name is [PII] and I'm from the provider's office. I'm calling you for claim information.
[AGENT][NEUTRAL] OK, yeah, I can look at a claim for you. I'm sorry, it's, uh, breaking up just a little bit. What did you say your name was?
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] [PII], OK.
[AGENT][POSITIVE] And can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you and then do you have the policy number?
[CUSTOMER][POSITIVE] Yes, I do. Yes.
[CUSTOMER][NEUTRAL] 01 moment. Can you help me with the spelling of the name, uh, one?
[AGENT][NEUTRAL] My name is spelled [PII]
[CUSTOMER][POSITIVE] Perfectly right and the member ID um 024.
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] OK, thank you and what was the name and date of birth for the insured?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] Do you have the date of birth?
[CUSTOMER][NEUTRAL] Date of birth
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] OK, thank you for verifying that [PII] and what was the date of service for this claim?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] I'm sorry, that was [PII]?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, and what was the bill amount, please?
[CUSTOMER][NEUTRAL] 1836.
[AGENT][NEUTRAL] OK, $1,836.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK thank you one moment.
[AGENT][NEUTRAL] [PII], what was the name of the uh provider's office?
[CUSTOMER][NEUTRAL] Anesthesia dynamic
[AGENT][NEUTRAL] I'm sorry, could you repeat that?
[CUSTOMER][NEUTRAL] Anastasia dynamic cells.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] I'm not showing that we received a claim uh for that amount from that provider. uh, do you possibly have the tax ID?
[CUSTOMER][NEUTRAL] 8234
[CUSTOMER][NEUTRAL] 30528.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] OK, yeah, [PII], we have not received that claim.
[CUSTOMER][NEUTRAL] Just a moment
[CUSTOMER][NEUTRAL] So you're saying there is no claim on file?
[AGENT][NEUTRAL] Correct, I don't have a claim for that provider.
[AGENT][NEUTRAL] For that date of service.
[CUSTOMER][NEUTRAL] Well
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Just allow me one moment.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So you're saying, OK, can you check for the bill charge amount 1764?
[AGENT][NEUTRAL] Yeah, I don't have an amount for that um I don't have a claim for that amount and none of the claims I have on file for this insured uh is from that provider.
[CUSTOMER][NEUTRAL] 000, OK, just a moment.
[CUSTOMER][NEUTRAL] Um, can you just help me?
[AGENT][NEUTRAL] Sorry.
[CUSTOMER][NEUTRAL] Uh, whether the patient was acting on the date of service or not.
[AGENT][NEUTRAL] Yeah, they were active, um, this policy's effective date was [PII].
[AGENT][NEUTRAL] [PII] and it is currently active.
[CUSTOMER][NEUTRAL] OK, we can fax the claim.
[AGENT][POSITIVE] Absolutely um let me know when you're ready for that fax number.
[CUSTOMER][NEUTRAL] Sure. What is that?
[AGENT][NEUTRAL] OK, it is 877.
[AGENT][NEUTRAL] 3659423
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] Um, help me with the reference number.
[AGENT][NEUTRAL] Reference number would just be my first name, last initial, and today's date. Uh, so my last initial is [PII] Was there anything else I could help you with, OK?
[CUSTOMER][NEUTRAL] Uh, just one more question, [PII], that we need to send the medical, uh, I'm sorry, we need to send the, no, uh, primary UB along with the same, right?
[AGENT][POSITIVE] That's correct, yes, we do need the primary EOB.
[CUSTOMER][POSITIVE] Perfect. Thank you, thank you. You have a good day. Bye.
[AGENT][POSITIVE] Of course, yeah, thanks for calling APL you too bye bye.
[CUSTOMER][NEUTRAL] Bye.