AccountId: 011433970860
ContactId: ee786942-27d0-4bc5-90f1-a1c1ff0c00e9
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 329029 ms
Total Talk Time (AGENT): 113389 ms
Total Talk Time (CUSTOMER): 146940 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/05/ee786942-27d0-4bc5-90f1-a1c1ff0c00e9_20250305T21:12_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Yes, hi. Uh, my name is [PII], and I wanted to find out if you guys received a bill from one of my providers.
[AGENT][NEUTRAL] OK, I can verify claim status for you. And what is your policy number?
[CUSTOMER][NEUTRAL] It's um let me see. It's 24,770.
[AGENT][NEUTRAL] Um, no, ma'am. That sounds like a group number. Do you have a copy of your card in front of you?
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, so the outpatient benefits certification number or in hospital. I don't know which one.
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] Either one is fond of those two.
[CUSTOMER][NEUTRAL] OK, so the in the hospital it's 0203.
[CUSTOMER][NEUTRAL] 6914 M as in Mary, L as in Louis 7.
[AGENT][NEUTRAL] OK, thank you. One moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK. And do you have a callback number, Ms. [PII], in case the call drops?
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] OK, and verify your date of birth and the mailing address, please.
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] My address is [PII].
[AGENT][NEUTRAL] OK. And what was the date of service of the claim?
[CUSTOMER][NEUTRAL] So it's [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, I do show we received a claim from a facility for that data service and we requested the primary EOB.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, you requested who to send that.
[AGENT][NEUTRAL] 1 2nd
[AGENT][NEUTRAL] It looks like we received it twice. Initially, the claim process is needing primary EOB and looks like we received it a second time and we're needing a detailed EOB.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So,
[CUSTOMER][NEUTRAL] And who are you requesting this to?
[AGENT][NEUTRAL] To the facility, um, looks let me see.
[CUSTOMER][NEUTRAL] OK, booker.
[AGENT][NEUTRAL] I, it says BB, I'm sorry, B R R H, so, um.
[CUSTOMER][NEUTRAL] Yeah, book.
[CUSTOMER][NEUTRAL] Hospital.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, OK, so you guys still didn't process anything and you're waiting on this you'll be.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, and when did you request it?
[AGENT][NEUTRAL] Uh, initially, uh, it looks like it was requested on, give me a moment.
[AGENT][NEUTRAL] Um, [PII] and then again on [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, um, so this is typically something that you request to the facility, OK, because I'm.
[AGENT][NEUTRAL] Or to any providers, because your policy you have with us is secondary only. So in order for us to process that primary EOV is needed.
[CUSTOMER][NEUTRAL] Mhm. Yeah.
[CUSTOMER][NEUTRAL] OK, um, OK, so that's from them to send it. So would they give it to me for me to provide it to you guys or or it has to come from the facility?
[AGENT][NEUTRAL] Well, most times providers or your primary insurance will send out an explanation of benefits for service that was performed. So you can contact your major medical and request that EOB for that data service and they can um send it to you and you can send it to us or we can wait for the provider to submit.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] OK, yeah, because they're sending me a bill. I know, you know, probably some of these things are covered by you guys, so I don't want to be paying, you know, this amount if I'm not responsible for it.
[CUSTOMER][NEUTRAL] Um, so you're saying it's been like a month and you're waiting for now when was this bill sent originally?
[AGENT][NEUTRAL] Uh, [PII].
[CUSTOMER][NEUTRAL] Oh, so like 6 months later after the procedure. OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So I'll see what's going on with uh Boca Regional and see if they can send you what you need and uh go from there.
[AGENT][NEUTRAL] Yes, ma'am, and if you like, I can give you our fax number and they can fax that information to us.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] Yeah, that would be great. What's the fax number?
[AGENT][NEUTRAL] OK, it's [PII].
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][POSITIVE] [PII]. Perfect.
[CUSTOMER][POSITIVE] OK. Very good. Thank you so much.
[AGENT][POSITIVE] Uh, yes, ma'am. Thank you for calling APL. Have a great rest of your day.
[CUSTOMER][NEUTRAL] You too. Bye-bye.
[AGENT][NEUTRAL] Bye.