AccountId: 011433970860
ContactId: f58adeaf-5692-4b36-90e4-4cb190022152
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 188619 ms
Total Talk Time (AGENT): 59770 ms
Total Talk Time (CUSTOMER): 71905 ms
Interruptions: 0
Overall Sentiment: AGENT=-0.2, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/13/f58adeaf-5692-4b36-90e4-4cb190022152_20250513T20:19_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes, [PII]. This is [PII] calling from Memory Healthcare regarding uh claim status.
[AGENT][NEUTRAL] OK, [PII], I can help you with claim status. Do you have a good callback number?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Actually, claim denied for primary EOB [PII]. Can you hear me?
[AGENT][NEUTRAL] Actually
[AGENT][NEUTRAL] Yes, you have the policy number of the patient?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] OK. Uh, 247-4401.
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] [PII]. Date of birth [PII].
[AGENT][NEUTRAL] Yeah, what was that date of service and bill charges?
[CUSTOMER][NEUTRAL] Uh, [PII] for the bid amount $399 even.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Looks like we received it a second time, uh, claim number 3,593,330.
[AGENT][NEUTRAL] C 423, 25.
[AGENT][NEUTRAL] Process 4 24 25.
[AGENT][NEGATIVE] And we did not get the primary explanation of benefits.
[CUSTOMER][NEUTRAL] Excuse me. That's the date of service, [PII], with about 399.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] I mean, uh, it's claim number ending with 290, right?
[AGENT][NEUTRAL] Uh, the original claim which we requested the EOB.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Yes, that, that one.
[CUSTOMER][NEUTRAL] What's that? Mm.
[AGENT][NEUTRAL] Uh there's a lot.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah, we requested the primary explanation of benefits and then a second claim was submitted again, a duplicate claim, but it didn't have the primary EOB.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I can send the uh copy of the primary via fax. What's the fax number?
[AGENT][NEUTRAL] Now fax number is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]. what's the documentation time defining limit?
[AGENT][NEGATIVE] Uh, no timely filing.
[CUSTOMER][NEUTRAL] Is that
[CUSTOMER][NEUTRAL] No, that's fine. OK, [PII], perfect. Uh, what's the last name, sir?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]. What's the reference number for this call?
[AGENT][NEUTRAL] A reference number is my name and today's date.
[CUSTOMER][POSITIVE] OK, [PII]. Have a great day.
[AGENT][POSITIVE] OK, thanks for APL. Bye-bye.
[CUSTOMER][NEUTRAL] Bye for now.