AccountId: 011433970860
ContactId: e588b64d-b912-4445-90d9-34738ef866aa
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1402140 ms
Total Talk Time (AGENT): 252510 ms
Total Talk Time (CUSTOMER): 501129 ms
Interruptions: 2
Overall Sentiment: AGENT=0.5, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/23/e588b64d-b912-4445-90d9-34738ef866aa_20250423T13:07_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hey, hi, this is [PII] calling from the priority service to check on the claim status.
[AGENT][NEUTRAL] And what did you say your name was?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, [PII], what is the policy number?
[CUSTOMER][NEUTRAL] 3
[CUSTOMER][NEUTRAL] 1477504. M as in Mike. L as in Lima, number 8.
[AGENT][POSITIVE] OK, perfect. Thank you.
[CUSTOMER][NEUTRAL] Well
[AGENT][NEUTRAL] OK, and then what's a good call back number in case our call gets dropped?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII], it's a direct line.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] OK, and then patient's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] And give me a moment.
[CUSTOMER][NEUTRAL] Station for cinemas.
[CUSTOMER][NEUTRAL] [PII] and the last name is [PII]. Date of birth is [PII].
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK. And then what was the first name again?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] First name, I'll spell it out, OK. [PII].
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] It looks like we have a different first name on file.
[CUSTOMER][NEUTRAL] Like
[CUSTOMER][NEUTRAL] It is [PII]
[AGENT][NEUTRAL] Yes.
[AGENT][POSITIVE] Mhm. OK, that's right.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then do you have a charge amount and a data service?
[CUSTOMER][NEUTRAL] Yes, just give me a moment.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Date of service was [PII].
[CUSTOMER][NEUTRAL] And the charge amount was 1590 $1,590845.96. Sorry, it is 1, I'll just again repeat it OK? 159845.96. OK.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK just one moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] You
[AGENT][NEUTRAL] OK, so we do not have a claim on file for that data service [PII].
[CUSTOMER][NEUTRAL] I
[CUSTOMER][POSITIVE] Actually, I can
[CUSTOMER][NEUTRAL] Yes. Actually, I can provide you uh the date of service once again. It is [PII], and I do have the claim number with me.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Oh you do? OK, so what's the claim number?
[CUSTOMER][NEUTRAL] 3576639
[AGENT][POSITIVE] OK, perfect. Thank you.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] OK, so it looks like the received date is [PII]. The process date is [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEGATIVE] And it looks like claim was denied.
[AGENT][NEUTRAL] Due to we are waiting the EOB.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK. So give me a moment and the primary also we have sent and I'll just let you know when we have submitted, OK?
[AGENT][NEUTRAL] OK. Would you like our claim mailing address or our fax?
[CUSTOMER][NEUTRAL] Just give me a moment, uh, because previously one of our user has been sent the primary UB uh through the mailing address, I guess. It is [PII] payer ID they have given, but mhm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Just give me a moment. It should not be the payer ID. It should. It is [PII]. Is this the mailing, uh, sorry, fax number?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, the fax number is [PII].
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] OK. Previously, I guess we sent to the wrong um fax. It was [PII]. It, this is wrong, right?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEGATIVE] Yes, that is wrong.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So we'll just send the primary UB to this fax number and uh what is the time you finally to submit this uh primary UB.
[AGENT][NEUTRAL] There is no filing limit to submit a claim.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Just give me a moment. And on one call, how many claims you're going to provide?
[AGENT][NEUTRAL] You're fine.
[AGENT][NEUTRAL] Sorry, what was that?
[CUSTOMER][NEUTRAL] In one call, how many claims you're going to provide?
[AGENT][NEUTRAL] So I show one claim for that data service.
[CUSTOMER][NEUTRAL] Uh, sorry, I'm just asking about, so I do have more, uh, 5 claims with me. Uh, can you please provide that information, the member ID and the policy will be, uh, sorry, uh, facility name and the member ID is different. You can provide that information.
[AGENT][NEUTRAL] You're needing the member ID?
[CUSTOMER][NEUTRAL] No, no, no. I'm just asking about. I do have more 4 claims with me. You will provide all, yes.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So, can you please provide me with the call reference number first for this?
[AGENT][NEUTRAL] Yes, it is [PII]
[AGENT][NEUTRAL] Last initial [PII] and today's date.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Thank you, [PII]. Just give me a moment. I'm just pull up with the other claim, OK?
[AGENT][POSITIVE] OK, take your time.
[CUSTOMER][NEUTRAL] And I think this is completely different, I guess. So it's stating the name is PM Real Station Hospital.
[CUSTOMER][NEUTRAL] Um, I think this is not your, please give me a moment.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I have.
[CUSTOMER][NEUTRAL] OK, you need first the member ID?
[AGENT][NEUTRAL] Yes, please.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 02473107
[AGENT][NEUTRAL] OK, just a second.
[CUSTOMER][NEUTRAL] you guys
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] Did you say 247-317?
[CUSTOMER][NEUTRAL] 3107.
[AGENT][POSITIVE] OK, perfect.
[AGENT][NEUTRAL] OK. And then what's the patient's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Patient's first name is
[CUSTOMER][NEUTRAL] [PII], and the last name is [PII] and the date of birth is [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, and then do you have a data service and charge amount for this one?
[CUSTOMER][NEUTRAL] Like
[CUSTOMER][NEUTRAL] Yes, date of service was [PII]. Charge amount was $39,466.37.
[AGENT][POSITIVE] OK, perfect.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] Yes, I do have the claim number as well. So did you find it uh or uh I need to provide it?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I did find it, but the claim number would help a bit more because it looks like there's 3 claims for that data service. Um, what's the claim number?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] So the claim number I do have is
[CUSTOMER][NEUTRAL] 3,563,830.
[AGENT][POSITIVE] OK, perfect. Thank you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] To
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] So this is also same denied for the primary UB. So actually I can see that we have sent through the mailing address so we can send it, uh, which you have provided now we can send it to that fax number.
[AGENT][NEUTRAL] Yes, you can send the EOB to that fax number I provided you.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] On the price we have sent to the mailing address. It is [PII].
[CUSTOMER][NEGATIVE] [PII]. This is not the correct one I guess.
[AGENT][NEUTRAL] No, so the claim address you want is the [PII].
[CUSTOMER][NEUTRAL] OK. We do have the fax number. I will just provide you with that fax number and just let me know when did you receive the claim and when it got denied for the primary, OK.
[AGENT][NEUTRAL] Yes, the fax number that I provided you earlier is the correct one.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Let me know the received and the denied date for this.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] OK, you're going to tell that or?
[AGENT][NEUTRAL] Just to.
[AGENT][NEUTRAL] Sorry.
[AGENT][NEUTRAL] Uh, yes, just, just, just one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so it looks like the received date was [PII].
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] And the process date was [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, we'll just send to the fax, OK, and, uh, give me a moment and I do have uh that clean with me. I'm just filling with that, OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] OK. Uh, it is [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] And
[AGENT][NEUTRAL] OK. Patient's first and last name and date of birth, please?
[CUSTOMER][NEUTRAL] [PII]. Last name is [PII].
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, I am not pulling up the policyholder for this policy number.
[CUSTOMER][POSITIVE] OK. OK, no issue.
[AGENT][NEUTRAL] 860751999.
[CUSTOMER][NEUTRAL] I think this is showing under the benefits and a card multiple plan.
[CUSTOMER][NEUTRAL] OK, I'll just contact with the correct number, OK? Just give me a moment.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] And one more last thing is with me.
[CUSTOMER][NEUTRAL] 5
[CUSTOMER][NEUTRAL] OK. The member ID I do have is
[CUSTOMER][NEUTRAL] 01570394 M [PII].
[AGENT][NEUTRAL] OK, and then patient's first and last name and date of birth, please?
[CUSTOMER][NEUTRAL] [PII], last name is [PII]. Date of birth is [PII].
[CUSTOMER][NEUTRAL] Actually this is also stating for the primary EOB I guess.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEGATIVE] Multiple times the primary was sent.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] So the, so the name.
[CUSTOMER][NEUTRAL] Yes, it was sent to the, yes.
[AGENT][NEUTRAL] So the name you provided me and the date of birth doesn't match this policy number.
[AGENT][NEUTRAL] Let me see if they have another policy.
[CUSTOMER][POSITIVE] Uh, claim will be well bought.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] I can see that [PII].
[CUSTOMER][NEUTRAL] And date of birth will be [PII]. I do have the claim number with me.
[AGENT][NEUTRAL] OK, and then what's the claim number?
[CUSTOMER][NEUTRAL] 352-289-8
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] that
[CUSTOMER][NEUTRAL] Study
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] That's not.
[CUSTOMER][NEUTRAL] Yes, uh,
[CUSTOMER][NEUTRAL] Did you receive the
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] The claim
[AGENT][NEUTRAL] Uh,
[CUSTOMER][POSITIVE] Thank
[AGENT][NEUTRAL] Let's see, oh, let's see, we did so I do see that claim.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEGATIVE] Let me see why it was denied.
[AGENT][NEUTRAL] Yeah, so we're still waiting the EOB.
[AGENT][NEUTRAL] Uh, let me double check one more place, OK?
[CUSTOMER][NEUTRAL] When did you receive the
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yeah,
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] What
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] OK, just one second, OK?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 460.
[CUSTOMER][POSITIVE] Correct
[CUSTOMER][NEUTRAL] You need
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK and then what provider's office is this?
[CUSTOMER][NEUTRAL] Really
[CUSTOMER][NEUTRAL] Florida West Side Hospital.
[AGENT][NEUTRAL] OK, so it looks like we're still awaiting the EOB.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK. When did you receive this claim?
[AGENT][NEUTRAL] Let's see
[AGENT][NEUTRAL] It looks like the received date was [PII].
[AGENT][NEUTRAL] And the process date was [PII].
[CUSTOMER][NEUTRAL] OK, then for the primary OB via fax number you have provided me, right?
[AGENT][NEUTRAL] Yes, ma'am. Mhm.
[CUSTOMER][NEUTRAL] OK, thank you so much for this information. So the call reference will be the same for all the calls, I guess.
[AGENT][POSITIVE] Yes, that's correct. Mhm.
[CUSTOMER][POSITIVE] Good
[CUSTOMER][POSITIVE] OK, thank you so much for this information. Have a great day ahead.
[AGENT][NEUTRAL] OK. Is there anything else I can help you with?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] No, this is enough already. I do have uh a total of 5 games and that 2 are a different one. So I have got all the 3 games on one call. Thank you.
[AGENT][POSITIVE] OK, yes, of course, thanks for calling APO have a good day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye.