AccountId: 011433970860
ContactId: ed47114e-585b-4023-b046-dcf742854be2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 292329 ms
Total Talk Time (AGENT): 108481 ms
Total Talk Time (CUSTOMER): 107209 ms
Interruptions: 1
Overall Sentiment: AGENT=0, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/02/ed47114e-585b-4023-b046-dcf742854be2_20250102T13:25_UTC.wav
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[AGENT][NEUTRAL] APL, this is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Uh, hi, [PII]. This is [PII] from provider's office. I'm looking for the claim status.
[AGENT][NEUTRAL] Sure, I can assist you with that. You said your name was [PII]?
[CUSTOMER][POSITIVE] It's uh B spells like alpha, Bravo [PII].
[AGENT][NEUTRAL] OK, could you repeat that because I could barely hear you.
[CUSTOMER][POSITIVE] It's Ahi spells like alpha, Bravo, Hotel India.
[AGENT][NEUTRAL] I have the call back number and the policy number, the number that you're inquiring claim status for today?
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] 0
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] And the policy number for the member?
[CUSTOMER][NEUTRAL] It's 01841277.
[AGENT][NEUTRAL] Can you verify that patient's name and date of birth and I'll be able to assist you.
[CUSTOMER][NEUTRAL] Uh it's [PII], with the date of birth of [PII].
[AGENT][NEUTRAL] Thank you and what is the date of service that you're inquiring about?
[CUSTOMER][NEUTRAL] Uh, date of service is [PII] with the charge amount of.
[CUSTOMER][NEUTRAL] $113.22.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] A
[AGENT][NEUTRAL] This claim was received [PII]. It was processed [PII]. There was no payment made on this claim.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] that's not.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEGATIVE] And the reason why there was no payment made is because the primary didn't make a payment. Nothing went towards deductible, co-pay or co-insurance.
[CUSTOMER][POSITIVE] Good
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] Uh, OK. One more.
[CUSTOMER][NEUTRAL] Uh, we did have the EU before the primary that they process this claim towards deductible.
[AGENT][NEUTRAL] So bear with me while I pull up the claim.
[CUSTOMER][NEUTRAL] My man
[CUSTOMER][NEUTRAL] Uh, sure.
[AGENT][NEGATIVE] On the ELB that we have, there was nothing went towards deductible, co-pay, or the co-insurance. There was zero balance for the patient responsibility and they said it was a duplicate of a claim.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Can we send that you be, what is the family falling to send those.
[AGENT][NEGATIVE] There's no timely filing. You can send an updated EOB.
[CUSTOMER][NEUTRAL] Mind you, maybe I'll get back to that.
[CUSTOMER][NEUTRAL] OK. So, uh, so can you help me with the fax number or something that I can send to you?
[AGENT][NEUTRAL] Yeah, give me one moment. So let me give you this claim number so this could be the reference number so when you send that information you say this is additional information for claim number 3505261.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] 505261, right?
[AGENT][NEUTRAL] 3505261
[CUSTOMER][NEUTRAL] 3505261
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] And I was like yeah.
[AGENT][NEGATIVE] The fax number would be, oh why is my stuff moving so slow.
[AGENT][NEUTRAL] 1877.
[AGENT][NEUTRAL] 3659423. That's 18773659423.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Well
[CUSTOMER][NEUTRAL] OK. It's 187736-59423, right?
[AGENT][POSITIVE] Yes, that is correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] You the
[CUSTOMER][NEUTRAL] OK. So I think that is it. This is the information I was looking for.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][POSITIVE] Thanks for calling APL and have a great day.
[CUSTOMER][NEUTRAL] You too. Call reference number, is there any?
[AGENT][NEUTRAL] We don't provide those unfortunately you can use my name and today's date as a reference. My name is [PII], and today's date.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] Thank you, [PII]. Have a good one.
[AGENT][POSITIVE] You're welcome. Thanks for calling AP as well. Goodbye.
[CUSTOMER][NEUTRAL] Bye-bye.