AccountId: 011433970860
ContactId: f926ff28-838b-4df2-ac98-2b3d46013901
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 264309 ms
Total Talk Time (AGENT): 85904 ms
Total Talk Time (CUSTOMER): 130226 ms
Interruptions: 3
Overall Sentiment: AGENT=0, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/23/f926ff28-838b-4df2-ac98-2b3d46013901_20250523T15:48_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hello, [PII]. This is [PII]. I'm calling on behalf of the provider. How are you, [PII]?
[AGENT][NEUTRAL] I'm good, how are you? And your name?
[CUSTOMER][NEUTRAL] I'm, my name is [PII] and the last initial is [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. How can I help you?
[CUSTOMER][NEUTRAL] I'm looking for a claim status for a patient.
[AGENT][NEUTRAL] OK, and do you have the policy number?
[CUSTOMER][NEUTRAL] Yes, 01677458 M as in Mike, L as in Lima.
[AGENT][NEUTRAL] And what's a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]. It's a direct line.
[AGENT][NEUTRAL] OK, can you go ahead and give me the date of service in this whole field?
[CUSTOMER][NEUTRAL] Yes, the total charge amount is
[CUSTOMER][NEUTRAL] $83 and event and the date of service is [PII].
[AGENT][NEUTRAL] OK, give me a moment to pull up the file.
[AGENT][NEUTRAL] The patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] All right, thank you, one moment.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Like.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] OK, so the claim number associated with this data service is 355.
[AGENT][NEUTRAL] 4384.
[AGENT][NEUTRAL] I show this claim was received.
[CUSTOMER][NEGATIVE] Yes, this claim has been denied.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] This claim is denied for primary UB, correct?
[AGENT][NEUTRAL] So you've already received the explanation of benefits?
[CUSTOMER][NEUTRAL] Yes, yes, we already received. So we have already sent a primary UB which is BCBS.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so you're
[CUSTOMER][NEUTRAL] And the BCBS has pro process uh towards the patient's responsibility and we have already resubmitted the primary OB. So could you please tell me why it was denied as uh they need primary UB.
[AGENT][NEUTRAL] OK, so when you said that you've already submitted it, did you submit it with the initial claim?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yes, with this, uh, initial claim like there was a
[CUSTOMER][NEUTRAL] American Public Life, uh, mansion, uh, insurance name and there is a
[CUSTOMER][NEUTRAL] Patient responsibility also mentioned on this claim form.
[AGENT][NEUTRAL] OK, so I'm pulling up the initial documentation that we received and I'm only showing the itemized bill. There is no primary EOB attached. Was it later sent to APL?
[CUSTOMER][NEUTRAL] Uh, it was submitted on, like, we have resubmitted the claim on [PII].
[AGENT][NEUTRAL] Is that when the initial claim was submitted to us?
[CUSTOMER][NEUTRAL] Um, yes, with this primary UP.
[AGENT][NEUTRAL] OK, so the initial claim was received on [PII].
[AGENT][NEGATIVE] And processed on [PII]. I don't show anything received in February.
[CUSTOMER][NEUTRAL] OK. So could you please give me the fax number so that we can uh send the primary UB and the claim form.
[AGENT][NEUTRAL] Fax number is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] So
[AGENT][NEUTRAL] 942 3.
[AGENT][NEUTRAL] Attention claims.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK, so we need to send on this uh fax number, yes?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Can I get a call reference number for this?
[AGENT][NEUTRAL] My name in today's date, [PII] First initial last name is [PII], and did you have any other questions, [PII]?
[CUSTOMER][POSITIVE] No, that's it. Thank you so much for your assistance. Have a great day. Bye-bye.
[AGENT][POSITIVE] You're welcome. Thanks for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] that