AccountId: 011433970860
ContactId: fa7e3bd6-fd07-4223-9309-5bd25638c2ed
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 453790 ms
Total Talk Time (AGENT): 119314 ms
Total Talk Time (CUSTOMER): 73978 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/29/fa7e3bd6-fd07-4223-9309-5bd25638c2ed_20250429T18:45_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII].
[CUSTOMER][NEUTRAL] And I'm calling to take the status, but first of all, what is your timely filing deadline?
[AGENT][NEGATIVE] Uh, we don't have any timely filing deadline anytime.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] I need to check the status of a claim please that that has been sent twice.
[AGENT][NEUTRAL] OK, I can help you with claim status on that. Do you have a good callback number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you. And do you have the policy number of the patient?
[CUSTOMER][NEUTRAL] Sure, 02446510.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] What was that patient name and date of birth?
[CUSTOMER][NEUTRAL] It's [PII] [PII].
[AGENT][NEUTRAL] And do you have the date of service and bill charges?
[CUSTOMER][NEUTRAL] [PII] and bill amount is $371 with an $11 secondary balance.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. Let me see.
[AGENT][NEUTRAL] OK, and let me get this pulled up. Hold on one moment.
[AGENT][NEUTRAL] Let's see
[AGENT][NEUTRAL] OK, you said 371, is that right?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] I think we've received it a few times. Let me see which one is right.
[AGENT][NEUTRAL] Right
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] OK, sorry, it's taking me a minute. I'm trying to find the original claim.
[AGENT][NEUTRAL] Is it for physician charges? Is that what it's for?
[CUSTOMER][NEUTRAL] It is.
[AGENT][NEUTRAL] it looks like actually lab, is that right?
[CUSTOMER][NEUTRAL] Um, let me, it is labs.
[AGENT][NEUTRAL] OK, OK, signature.
[CUSTOMER][NEUTRAL] [PII] was the was the MD.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] For the
[AGENT][NEUTRAL] 3583
[AGENT][NEUTRAL] OK, I know it looks like we originally requested an explanation of benefits.
[AGENT][NEUTRAL] The primary.
[AGENT][NEUTRAL] And then did, did, did y'all submit that along with the duplicate claim? Let me see, is that for let me see, 53.
[AGENT][NEUTRAL] Maybe they missed the, we got a duplicate claim on [PII].
[AGENT][NEUTRAL] Let me see if the primary EOB was attached.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So this I resubmitted this on [PII] you you received it in April.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] Well, we received the original.
[AGENT][NEUTRAL] Let me see, that's just the heck or the hexa, OK.
[AGENT][NEUTRAL] Uh, we received the original on
[AGENT][NEUTRAL] Oh, I see the first submission was
[AGENT][NEUTRAL] [PII]. Let me make sure I'm not messing this.
[AGENT][NEUTRAL] So you submitted it in January as well?
[AGENT][NEUTRAL] Is that correct?
[CUSTOMER][NEUTRAL] Yeah, that, that's when the claim was submitted in January. y'all just received it on [PII].
[AGENT][POSITIVE] Yeah, and we were sure.
[CUSTOMER][NEUTRAL] Hold on just a moment.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] I did
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Can can you hold one moment? Can you hold one moment?
[CUSTOMER][POSITIVE] OK, go ahead, I'm so sorry.
[AGENT][NEGATIVE] OK, yeah, so I don't show that we ever got it in January, but we received it twice in April. Uh, the first time it was denied because we needed the primary EOB and then the second submission.
[AGENT][NEGATIVE] We received the claim again, but it didn't have a primary EOB attached. It was just the CMS 1500 again.
[CUSTOMER][NEUTRAL] OK, can this be faxed over to you?
[AGENT][POSITIVE] Yes, absolutely. Fax number is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Alright, do you have a reference number for this call?
[AGENT][NEUTRAL] A reference number just my.
[CUSTOMER][NEUTRAL] And I'll get that back
[AGENT][NEUTRAL] OK, a reference number is just my name, [PII], and then today's date.
[CUSTOMER][NEUTRAL] OK, I'm gonna get that faxed over to you with the prime with the primary EOB.
[AGENT][POSITIVE] OK, perfect. All right. Thanks for calling APL. I hope you have a good day. Bye-bye.
[CUSTOMER][POSITIVE] Thank you very much.
[CUSTOMER][NEUTRAL] Mhm.