AccountId: 011433970860
ContactId: 0138405b-38a2-440c-b03d-755279c8224a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 219529 ms
Total Talk Time (AGENT): 72387 ms
Total Talk Time (CUSTOMER): 78739 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/31/0138405b-38a2-440c-b03d-755279c8224a_20250331T14:37_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yeah, hi, this is [PII] calling from provider's office, and I'm looking for a claim status. Could you help me with that, [PII]?
[AGENT][POSITIVE] I'm, yep, I'm happy to check on a claim for you today, [PII]. Do you have the patient's policy number?
[CUSTOMER][NEUTRAL] Yeah, I do have that. It's 02460345.
[AGENT][POSITIVE] Thank you. And do you have a good callback number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes, I do have the callback number. It's [PII]. That's a direct line.
[AGENT][NEUTRAL] Thank you. And can I get the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] Yup. The patient's name is [PII].
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][NEUTRAL] Thank you. And then date of service?
[CUSTOMER][NEUTRAL] The service on the claim is [PII].
[AGENT][NEUTRAL] And the build them out?
[CUSTOMER][NEUTRAL] Hold on.
[CUSTOMER][NEUTRAL] The bill amount is $17,957 even.
[AGENT][POSITIVE] Thank you. One moment.
[AGENT][NEUTRAL] So, we did receive a claim for the state of service, claim was received on [PII].
[AGENT][NEUTRAL] Uh, the claim was denied [PII]. We requested the primary explanation of benefits.
[CUSTOMER][POSITIVE] Yes ma'am. Thank you so much for that information.
[CUSTOMER][NEUTRAL] And actually, we have sent the claim again on [PII] with the primary UB. Could you check if there is a claim on the loan out?
[AGENT][NEGATIVE] I do see another claim on file, but no explanation of benefits. It was denied as a duplicate.
[CUSTOMER][NEUTRAL] Could you check the back of the climb, backside of the climb? Could you check if there is a, you'll be attached or not?
[CUSTOMER][NEUTRAL] On this page.
[AGENT][NEGATIVE] We did not receive any explanation of benefits.
[CUSTOMER][NEUTRAL] OK, ma'am, that's also fine. May I get the claim number?
[AGENT][NEUTRAL] 354.
[AGENT][NEUTRAL] 2681.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Thank you so much. And may I know, can we send a corrected claim or do we have to send a pre explanation of benefits alone?
[AGENT][NEUTRAL] Uh, yes, you can send the explanation of benefits along with a corrected claim.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, ma'am, that's fine. And
[CUSTOMER][NEUTRAL] And may I get the call reference number?
[AGENT][NEUTRAL] Call reference is my name with my last initials in today's date. My name again is [PII], which is [PII] My last initial is [PII].
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][POSITIVE] Yes, thank you so much, sir, and
[CUSTOMER][POSITIVE] Have a wonderful day. Thank you so much for your assistance.
[AGENT][POSITIVE] You're welcome. Thank you for calling APL. Have a good day.