AccountId: 011433970860
ContactId: fdcb6a45-c6c4-41bc-9410-bb1f1717dcb7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 516260 ms
Total Talk Time (AGENT): 135310 ms
Total Talk Time (CUSTOMER): 183222 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/07/fdcb6a45-c6c4-41bc-9410-bb1f1717dcb7_20250207T17:14_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This speaking. May I help you?
[CUSTOMER][NEUTRAL] Um, yes, I was calling, um, regarding an EOB request. Um, I called and got a status of a claim. This was yesterday I spoke with someone named [PII] and she found the claim that I was needing and said she was gonna fax the EOB. Now I haven't received it, so I didn't know how long it would take.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, um, and your name is? I'm sorry.
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] And Ms. [PII], what's that policy number, please?
[CUSTOMER][NEUTRAL] Um, it is.
[CUSTOMER][NEUTRAL] 022038887.
[AGENT][NEUTRAL] OK, see. And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] I do [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and that patient's name, date of birth?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] OK. And what was the date of service or did she give you the claim number?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Well, actually she didn't let me see, give me a claim number because I've called like about 4 or 5 times, well about 3 or 4 times this week. Two of the reps couldn't find the claim, but she found it yesterday, so, um, it, I don't have the claim number, but it was a date of service of [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, there were 2 claims submitted, I understand, um.
[CUSTOMER][NEUTRAL] But I was looking for one that with the total amount of $308.
[AGENT][NEUTRAL] OK, give me one moment.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] For 308. And do you have a balance after primary?
[CUSTOMER][NEUTRAL] Um, 60.
[AGENT][NEUTRAL] 60, OK.
[AGENT][NEUTRAL] Give me one moment.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And you're calling from?
[CUSTOMER][NEUTRAL] Um, it's Dominion Behavioral Healthcare.
[AGENT][NEUTRAL] OK, I think I found it. Let me double check, give me one moment.
[AGENT][NEUTRAL] Um, you said the total charge amount was 308?
[CUSTOMER][NEUTRAL] Uh huh.
[CUSTOMER][NEUTRAL] I don't know where she found it because every other rep I spoke to.
[CUSTOMER][NEUTRAL] Didn't find one. They found another one for like $187 or something like that.
[AGENT][NEUTRAL] Uh, what was the procedure code?
[CUSTOMER][NEUTRAL] Um, 992-05 and I don't think you all cover that anyway.
[AGENT][NEUTRAL] 19205. Give me one moment. Let me look at another spot.
[AGENT][NEUTRAL] 920.
[AGENT][NEUTRAL] See.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Give me one moment, let me see cause
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Ouch
[AGENT][NEUTRAL] Um
[AGENT][NEUTRAL] 36.
[AGENT][NEUTRAL] I wonder where she found the claim because I see another, but it's for a different amount. Um.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] See.
[CUSTOMER][NEUTRAL] Yeah, we had one for 150.
[AGENT][NEUTRAL] 412.
[AGENT][NEUTRAL] Yeah, and then
[AGENT][NEUTRAL] I see it a claim for uh that data service for that code, but it was for 18,780.
[CUSTOMER][NEUTRAL] That's the, well, actually that might be what I'm needing because I don't know what like I said I gave her, oh, you know what, let me see, yeah, because I gave her the 308 total because again um the other representatives I spoke with did keep telling me about a claim for 18,780 and like I said I don't know where that came from but um.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I don't know if that's what she was looking at or because if it's the same code and whatever I could I could use that.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let's see, yeah.
[CUSTOMER][NEUTRAL] But I don't know. Like I said, I don't know. She did say, I said $308 and I was, and I asked her I said, well, um, I said, wow, you found it. I said, but nobody else could find it for 308. I don't know.
[AGENT][NEUTRAL] Mhm.
[AGENT][MIXED] And the funny, when I say funny, but the thing is on the claim, it shows or on the EOB it showed a total amount of 308.
[CUSTOMER][NEUTRAL] Right
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] I'm confused to give me one moment to check one more spot.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. Yeah, I mean, I'm assuming this is the one you're needing because like I said, on the EOB it shows the total charge amount of 308 and it has that procedure code from y'all's office, um, but yeah, I can definitely fax that to you.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, what's your fax number, Ms. [PII]?
[CUSTOMER][NEUTRAL] It's 804.
[CUSTOMER][NEUTRAL] 355.
[CUSTOMER][NEUTRAL] 9966 and I'm gonna spell my name for you.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, it's MI.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK. And you said the fax number [PII]?
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK, I will fax this over to you in a few moments.
[CUSTOMER][NEUTRAL] OK, and I'm sorry, what was your name?
[AGENT][NEUTRAL] It's [PII], last [PII] [PII].
[CUSTOMER][POSITIVE] Alright, thank you so much [PII] you have a great rest of the day.
[AGENT][POSITIVE] Uh, you too, Ms. [PII]. Thank you for calling APL. Have a great weekend.
[CUSTOMER][NEUTRAL] You too bye bye