AccountId: 011433970860
ContactId: 04b75fb2-16a4-454e-b047-eb49bd625bc6
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 391920 ms
Total Talk Time (AGENT): 135174 ms
Total Talk Time (CUSTOMER): 77055 ms
Interruptions: 1
Overall Sentiment: AGENT=0.6, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/04/04b75fb2-16a4-454e-b047-eb49bd625bc6_20250204T15:25_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yeah, I'm I'm looking for the claim status.
[CUSTOMER][NEUTRAL] That's how you are.
[AGENT][NEUTRAL] OK, [PII], you're needing claim status, is that correct?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yes, right.
[AGENT][POSITIVE] Yes, I can help you. And [PII], what is your callback number?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] We
[AGENT][NEUTRAL] Thank you and [PII], how many claims do you have to check status on?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] One claim.
[AGENT][NEUTRAL] OK. Yes, I can help you. And what is that member's policy number?
[CUSTOMER][NEUTRAL] Yeah, 1070427.
[CUSTOMER][NEUTRAL] I
[AGENT][POSITIVE] Thank you, one moment please.
[CUSTOMER][NEUTRAL] I.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] One moment, [PII].
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] And [PII], any information that I do provide for you today will be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yeah, patient name is?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII] and the date of birth.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And the date of service and total bill amount?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Bye.
[CUSTOMER][NEUTRAL] Yeah, [PII].
[CUSTOMER][NEUTRAL] And the total bill amount, $46,688 even.
[AGENT][NEUTRAL] And you get, again, you said the date of service is [PII]. Is that correct?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Yes, right.
[AGENT][NEUTRAL] OK, so this claim was received on [PII] processed on [PII].
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] The claim number.
[AGENT][NEUTRAL] It's 355-092-7.
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] This claim has been denied, [PII].
[AGENT][NEUTRAL] And the reason for the denial on this claim, excuse me, states to please provide copies of your explanation of benefits from your primary insurance carrier.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Just.
[CUSTOMER][NEUTRAL] Can you provide me a fax number or mailing address?
[AGENT][NEUTRAL] Our claims fax number is [PII] Attention claims.
[AGENT][NEUTRAL] And then what do you show for the claim's mailing address?
[CUSTOMER][NEUTRAL] Can you repeat once again?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] You go ahead.
[CUSTOMER][NEUTRAL] OK, and what's the timely filing limit?
[AGENT][NEGATIVE] There's no timely filing?
[AGENT][NEUTRAL] And if you need a copy of this explanation of benefits, [PII], you can go to our portal to print that yourself by going to [PII].
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And the timelyifying limit?
[AGENT][NEUTRAL] I already explained to you, um, [PII], that there is no timely filing limit.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Just a minute, hold on.
[CUSTOMER][NEUTRAL] Yeah, can you provide me your mailing address?
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Of
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And the zip code is [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, thank you first. And can you give me a call reference number?
[AGENT][NEUTRAL] My name in today's date.
[CUSTOMER][NEUTRAL] Uh, can you repeat your name once again?
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And are you still there?
[CUSTOMER][POSITIVE] Yeah, OK. Thank you for assisting me. Have a good day. Bye-bye.
[AGENT][POSITIVE] You're very welcome. If that's all I can help you with, thank you again for calling APL. I hope you have a nice day also.
[CUSTOMER][NEUTRAL] Yeah.