AccountId: 011433970860
ContactId: e78aaa15-52c9-46fc-85dc-4a166cc6e2f9
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 438209 ms
Total Talk Time (AGENT): 117170 ms
Total Talk Time (CUSTOMER): 153267 ms
Interruptions: 1
Overall Sentiment: AGENT=0.3, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/10/e78aaa15-52c9-46fc-85dc-4a166cc6e2f9_20250210T13:49_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling UPL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, uh, my name is Via calling from provider office to check on the claim status.
[AGENT][NEUTRAL] OK, and what can you spell your first name for me please?
[CUSTOMER][NEUTRAL] Yes, uh, the first name is, uh,
[CUSTOMER][NEUTRAL] [PII]. Could you spell out your name for me?
[AGENT][NEUTRAL] OK. Can you spell your name for me?
[CUSTOMER][NEUTRAL] Me.
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] OK, my name is [PII], first initial last name is [PII].
[CUSTOMER][NEUTRAL] not
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] And [PII], what's a good phone, what's a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] And the phone callback number is [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII] or [PII]?
[CUSTOMER][NEUTRAL] Yes. [PII].
[AGENT][NEUTRAL] OK, and what's the policy number?
[CUSTOMER][NEUTRAL] And my policy is 019.
[CUSTOMER][NEUTRAL] 862-669
[AGENT][NEUTRAL] OK, and if you can verify the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] And the patient name was [PII] and the date of birth is [PII].
[CUSTOMER][NEUTRAL] Yeah, based in the, based in the information.
[AGENT][POSITIVE] Thank you for that information, [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And you said that you're checking a claim status for what date of service?
[CUSTOMER][NEUTRAL] checking claim status uh data service in um [PII].
[AGENT][NEUTRAL] And the amount?
[CUSTOMER][NEUTRAL] And the bill amount is
[CUSTOMER][NEUTRAL] $2000.
[CUSTOMER][NEUTRAL] I'm the.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] That yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Start something.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, so I show that this claim was received, uh, [PII].
[AGENT][NEUTRAL] Uh, processed on [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And I'm showing that we are requesting a copy of the primary insurance explanation of benefits.
[CUSTOMER][NEUTRAL] Copy of UB right?
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, what is the claim status now?
[AGENT][NEUTRAL] We denied it for a copy of the primary insurance explanation of benefits.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Any other questions I can help out with today?
[CUSTOMER][NEUTRAL] Yes, uh, give me a moment.
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Any other questions I can help out with today?
[CUSTOMER][NEUTRAL] Hello. It is
[CUSTOMER][NEUTRAL] Uh, uh, [PII], uh, thank you for your patience. May I know who's primary on the data service?
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Baseball
[AGENT][NEUTRAL] And you can also check with the patient as far as who their primary insurance carrier is as well. One moment.
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] I said that you can also check with your patient to verify who their primary insurance carrier is. One moment.
[CUSTOMER][NEUTRAL] No. OK, OK.
[AGENT][NEUTRAL] Are you calling on behalf of the provider's office?
[CUSTOMER][POSITIVE] Yes, provided office.
[AGENT][NEUTRAL] Our record gender, Blue Cross and Blue Shield.
[CUSTOMER][NEUTRAL] Blue Cross Blue Shield, right?
[AGENT][NEUTRAL] Yes, but you'll need to check with the patient as well to verify.
[CUSTOMER][NEUTRAL] OK. Blue Cross Blue Shield is a primary insurance, right?
[AGENT][NEUTRAL] As far as our records indicate, but you should also check with the patient to verify their primary insurance carrier.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Any other questions?
[CUSTOMER][NEUTRAL] Yes, yes, one second.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Any other questions?
[CUSTOMER][NEUTRAL] Yes, um, I, uh, may I know the member ID?
[AGENT][NEUTRAL] It's the number that you gave me.
[CUSTOMER][NEUTRAL] Same num same member ID, right?
[CUSTOMER][NEUTRAL] OK. May I know the uh my mailing address?
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK. May I know the timely filing limit?
[AGENT][NEUTRAL] To submit a claim?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEGATIVE] There's no timely filing limit.
[CUSTOMER][NEUTRAL] OK. Fax number?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] May I know the claim number?
[AGENT][NEUTRAL] 347-087-1 anything else I can assist with today, [PII]?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] I guess on your call reference number for this claim.
[AGENT][NEUTRAL] It's my name in today's date.
[CUSTOMER][POSITIVE] OK. Thank you, [PII]. Have a great day. Thank you for your kindness.
[AGENT][POSITIVE] You too, thanks for calling APL have a good day.
[CUSTOMER][POSITIVE] Thank you, stay safe.