AccountId: 011433970860
ContactId: ebb5a556-b054-4010-881d-56634d58cfe2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 268899 ms
Total Talk Time (AGENT): 99268 ms
Total Talk Time (CUSTOMER): 145932 ms
Interruptions: 1
Overall Sentiment: AGENT=2.6, CUSTOMER=1.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/02/ebb5a556-b054-4010-881d-56634d58cfe2_20250102T15:45_UTC.wav
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[AGENT][NEUTRAL] Hi, thank you for calling APL. This is [PII]. How can I help you today?
[CUSTOMER][NEUTRAL] Good morning [PII]. My name is [PII], and I'm calling from our billing unit here in [PII]. I was wondering if I could speak to you if you have a claim on file for a mutual number because the data service is 89-2024.
[AGENT][POSITIVE] Yeah, I'd love to help you look at a claim status today, Ms. [PII]. Um, do you mind if real quick I get a good call back number for you?
[CUSTOMER][NEUTRAL] [PII]. Thank you [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Yeah, my pleasure. And what is the member's policy number?
[CUSTOMER][NEUTRAL] Oh, wait, what did I just put that? Oh, forgive me policy number. OK, so we want the, uh, alright, hold on, um.
[CUSTOMER][NEGATIVE] Come on come on. Oh no, what did I do with it?
[CUSTOMER][NEUTRAL] Here we go, 0244.
[CUSTOMER][NEUTRAL] 963 0.
[CUSTOMER][NEUTRAL] ML 8.
[AGENT][POSITIVE] Wonderful and your patient's first and last name and date of birth, please?
[CUSTOMER][POSITIVE] Thank you, [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Perfect and.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][POSITIVE] Thank you [PII].
[AGENT][NEUTRAL] Thank you and, and I wrote down the date of service on that claim is [PII]. Was that correct?
[CUSTOMER][POSITIVE] Yes, good memory.
[AGENT][POSITIVE] Alright, perfect.
[AGENT][NEUTRAL] Let me see.
[CUSTOMER][POSITIVE] Thank you so much.
[AGENT][NEUTRAL] Yeah absolutely so it looks like I actually don't have like a claim on file for [PII] for that date of service.
[CUSTOMER][NEUTRAL] Now, let me ask you this, [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] Uh, cause it's, excuse me, it's rejecting in the clearing house.
[CUSTOMER][NEUTRAL] So, excuse me, it says the patient has a primary insurance coverage with another carrier. So a member sent it out to United Healthcare.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] But UnitedHealthcare is not.
[CUSTOMER][NEUTRAL] Accepting it. Uh, and so,
[CUSTOMER][NEUTRAL] I wanted to verify with you APL that is not the patient's primary, is it?
[AGENT][NEUTRAL] No, we are their secondary, so we follow their primary insurance. We're like a gap coverage.
[CUSTOMER][NEUTRAL] Got you. Now, would you be able to tell me if it's United Healthcare?
[AGENT][NEUTRAL] Oh, like what the actual, um, what their primary insurance is? I can look into that for you, yes.
[CUSTOMER][NEUTRAL] Could you please, [PII], cause
[AGENT][NEUTRAL] Let me see.
[CUSTOMER][NEUTRAL] So, uh, we can get this taken care of. Uh, uh, I don't know why it's not going with United Healthcare.
[AGENT][NEUTRAL] Yeah, I show on our file that they have Blue Cross Blue Shield for their uh major medical.
[CUSTOMER][NEUTRAL] Would you be able to provide that ID so I can verify it with with Epic and then get this out to Blue.
[AGENT][NEUTRAL] Actually I don't have that so like I can see that the group uses Blue Cross Blue Shield because they have to have major medical to have our policy, but I, we don't have access to like the individual's policy numbers.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, I will work on that, but I wanna thank you for verifying no United Healthcare and let's go with Blue Cross Blue Shield. Thank you for making my day a beautiful day.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] You're welcome. I'm glad I could help.
[CUSTOMER][POSITIVE] Yes, and [PII]. And lastly, would you have a reference number for our call, please?
[AGENT][NEUTRAL] You bet you, Ms. [PII]. It's gonna be my name, [PII], um first initial, last name, [PII], and today's date.
[CUSTOMER][POSITIVE] [PII] happy healthy new year there Ali beautiful.
[AGENT][POSITIVE] Likewise, Ms. [PII], take care. Thanks for calling APL. Have a great day and a fabulous year.
[CUSTOMER][NEUTRAL] Oh absolutely and one more question. May I, right, and then and when we go to, uh, send it to APL we're gonna go with [PII].
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][POSITIVE] [PII]. Thank you for verifying everything. You are the best.
[AGENT][POSITIVE] Well thank you Miss [PII]. I hope you take care and I hope you have a great day.
[CUSTOMER][POSITIVE] I got you thank you so much bye bye.
[AGENT][POSITIVE] My pleasure, bye bye.