AccountId: 011433970860
ContactId: f3787dad-d991-4d72-ba0f-e003f8678cc7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 622530 ms
Total Talk Time (AGENT): 192503 ms
Total Talk Time (CUSTOMER): 247499 ms
Interruptions: 1
Overall Sentiment: AGENT=0.6, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/11/f3787dad-d991-4d72-ba0f-e003f8678cc7_20250211T16:38_UTC.wav
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[AGENT][NEUTRAL] [PII], this is how may I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII] and I'm calling from provider office and this call may be recorded for quality and training purposes. Um, I'm checking for claim status. Could you please help me with that?
[AGENT][NEUTRAL] I can help you, [PII]. You can also check your claim status online at secured.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And do you have the policy number?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, it is 01629112 M as in Mike L as in Lima number 8.
[AGENT][NEUTRAL] And what's a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yeah, it is [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And what is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] It is [PII]. Date of birth it's uh [PII].
[AGENT][POSITIVE] Thank you for that information and we're checking claim status.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] And what's the date of service in charge?
[CUSTOMER][NEUTRAL] It is uh [PII] build amount $500 even.
[AGENT][POSITIVE] Thank you.
[AGENT][POSITIVE] Let me pull up the information and we'll be able to help you.
[CUSTOMER][NEUTRAL] Yeah sure
[AGENT][NEUTRAL] We're needing a copy of the major medical explanation.
[AGENT][POSITIVE] Of benefits
[AGENT][NEUTRAL] I do show that this claim was received.
[AGENT][NEUTRAL] [PII] processed on the [PII] and what is the name of this facility?
[CUSTOMER][NEUTRAL] It is a diagnostic Center for Women LLC.
[AGENT][NEUTRAL] OK, and the claim number associated with this state of service is 354.
[AGENT][NEUTRAL] 6984.
[CUSTOMER][NEUTRAL] OK, 354-6984, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK. Just a minute.
[CUSTOMER][NEUTRAL] All right, uh, yeah, can you help me with the call reference number for this claim?
[AGENT][NEUTRAL] You'll use my name in today's date is your reference [PII].
[AGENT][NEUTRAL] ONYA first initial last name is [PII].
[CUSTOMER][NEUTRAL] OK. Uh, I have 2 more claims. Can you please help me with that also?
[AGENT][NEUTRAL] Next policy number?
[AGENT][NEUTRAL] Is it for the same person or a different patient?
[CUSTOMER][NEUTRAL] Yeah, sure, just a
[CUSTOMER][NEUTRAL] This for a different patient.
[AGENT][POSITIVE] And remember you can also check your status online as well and I can help you create the account if you would like.
[CUSTOMER][NEUTRAL] Uh, actually I have it, but uh.
[CUSTOMER][NEUTRAL] For this one I for detailed information, I'm not getting that claim on the file on the portal.
[AGENT][NEUTRAL] OK, do you wanna log in? You mean the one that I just status?
[CUSTOMER][NEUTRAL] I don't know why because if we if we have a.
[AGENT][NEUTRAL] The one that, that was just at us?
[CUSTOMER][NEUTRAL] Yeah because if it.
[CUSTOMER][NEUTRAL] Mhm yeah.
[AGENT][NEUTRAL] OK, what, what happened when you tried to, to um log in?
[CUSTOMER][NEUTRAL] I, yeah, actually if we have only the claim number then only we can pull up that status of the claim, but without the claim number we can't pull up that status.
[AGENT][NEUTRAL] Yeah, there's actually two ways that you can search for the claim. One is using the claim number, the patient's name and date of birth, but there's another option in which to, uh, search for the, the EOB as well.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, just hold on a second, let me check for what you're saying in this one. let me log in this one first.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So we can confirm it and for the future it will be helpful for me.
[AGENT][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] American.
[CUSTOMER][NEUTRAL] Li
[CUSTOMER][NEUTRAL] January
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEGATIVE] I think the system is slow.
[CUSTOMER][NEUTRAL] It is still showing me submitting logins, but uh.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Come on, come on.
[CUSTOMER][NEUTRAL] It was showing me any kind of error on this one. Let me try one more time.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And you
[AGENT][NEUTRAL] What web address are you entering for the portal?
[CUSTOMER][NEUTRAL] Yeah, it's secure [PII].
[AGENT][NEUTRAL] Is it secured. [PII]? OK, OK, OK.
[CUSTOMER][NEUTRAL] Yeah, yes, yeah.
[CUSTOMER][NEGATIVE] And it was showing like oops there is in an error look for experienced technical difficulties if you want to continue experience issue please contact customer service [PII].
[AGENT][NEUTRAL] OK, so from the home page, um, are you clicking the log in but button or the new user button?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] No, it's log in button only.
[AGENT][NEUTRAL] OK, so you've already
[CUSTOMER][NEUTRAL] Log in and I'm having a user name also I have already logins I think right now it was not uh I think right now only they're having an issue in the portal something like that.
[AGENT][NEUTRAL] OK, so you have already created an online account under the tax ID number. Give me a second, let me check that for you.
[CUSTOMER][NEUTRAL] For
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Because I'm, I'm actually in the site, so I think it's working. Give me a second and what tax ID number did you use?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Give me that one more time.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And we can go ahead and proceed with your next one. I'm waiting for a response.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah, it may be down.
[CUSTOMER][NEUTRAL] So can we move for the next, yeah, so can we check the claim status for the other patient?
[AGENT][NEUTRAL] Yeah, it may be down.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah, we can go ahead and proceed.
[CUSTOMER][NEUTRAL] Yeah, the next, uh, patient member ID it is [PII].
[AGENT][NEUTRAL] Mhm. And what's the patient's name and date of birth?
[CUSTOMER][NEUTRAL] It is [PII]'s date of birth is [PII].
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] And what's the data service?
[CUSTOMER][NEUTRAL] Yeah, the date of service, it is uh [PII] with the bill amount of uh $500 even.
[AGENT][NEUTRAL] OK, so on this one we need the primary explanation of benefits. Uh, the claim number is 355.
[AGENT][NEUTRAL] 1205.
[AGENT][NEUTRAL] Showing a received date of [PII] process date of [PII].
[AGENT][NEUTRAL] 25.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Just want to note down this one and for the same date of service there is one more claim.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] And that's the bill amount is $620 even.
[AGENT][NEUTRAL] And what's the procedure code on the claim?
[CUSTOMER][NEUTRAL] 77066 and G 0279.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] Oh that's good
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] OK, I only see a code of 770,664,450.
[CUSTOMER][NEUTRAL] Uh yeah.
[CUSTOMER][NEUTRAL] I think it's probably it's a partially billed uh so what is the status for that one for 77066?
[AGENT][NEUTRAL] Need the need the primary EOB as well. Claim number is 355.
[AGENT][NEUTRAL] 12:09.
[AGENT][NEUTRAL] Showing a receipt
[CUSTOMER][NEUTRAL] Sorry, what did you said? 355?
[AGENT][NEUTRAL] 12091209.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Received and processed on the same date as the other one?
[CUSTOMER][NEUTRAL] OK, [PII] and [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, uh, can you please, uh, [PII] can please provide me the primary EOB to send the fax the primary OB. Can you provide me the fax number?
[AGENT][NEUTRAL] OK, what did you say before the fax number? I didn't understand what you said.
[CUSTOMER][NEUTRAL] Uh, to send the primary you'll be, I require the primary, uh, fax number, so just to require.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, the fax number is [PII].
[AGENT][NEUTRAL] 365.
[AGENT][NEUTRAL] 942 3.
[CUSTOMER][NEUTRAL] And what will be the attention?
[AGENT][NEUTRAL] Claims.
[CUSTOMER][NEUTRAL] Got it.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] And uh yeah, thank you so much have a great day, stay safe and bye for now.
[AGENT][POSITIVE] Oh, you're welcome and thanks for calling APL [PII]. Have a good day as well.
[CUSTOMER][NEUTRAL] Any.