AccountId: 011433970860
ContactId: 05a858e2-e56f-47e6-b177-8361740196b5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 391750 ms
Total Talk Time (AGENT): 80172 ms
Total Talk Time (CUSTOMER): 137365 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/19/05a858e2-e56f-47e6-b177-8361740196b5_20250519T17:39_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yeah, hi, [PII]. This is [PII] calling from provider offers to check the claim status.
[AGENT][NEUTRAL] ACO, I can help you with claim status. Do you have a good callback number?
[CUSTOMER][NEUTRAL] The callback number is [PII].
[AGENT][NEUTRAL] And policy number for the patient?
[CUSTOMER][NEUTRAL] The member's policy ID is, uh sorry, it's 024.
[CUSTOMER][NEUTRAL] 67155.
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] The patient's name as
[CUSTOMER][NEUTRAL] Oh,
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII] and the date of birth is on.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And date of service and bill charges?
[CUSTOMER][NEUTRAL] The date of services on [PII], with the bill amount is $174,210 even.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] Uh, it looks like we received the claim on.
[AGENT][NEUTRAL] Receive [PII]. Process [PII], needing a primary explanation of benefits.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, so I have already submitted the primary UB to the fax number. Can you double check again?
[CUSTOMER][NEUTRAL] I I
[AGENT][NEGATIVE] Uh, yes, we have not received it.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, I definitely was that that I get to the fax number as [PII]. Is that right?
[AGENT][POSITIVE] Yes, that's right.
[CUSTOMER][NEUTRAL] Yeah, yes, definitely. I understand that. Can you check again, uh, check another claim?
[AGENT][NEUTRAL] For the same patient or a different one?
[CUSTOMER][NEUTRAL] No, it's for the front.
[AGENT][NEUTRAL] OK, hold on a moment.
[AGENT][NEUTRAL] State of or the policy number of the patient?
[CUSTOMER][NEUTRAL] Yeah, it's 019.
[CUSTOMER][NEUTRAL] 785-557.
[AGENT][NEUTRAL] And the patient name and date of birth?
[CUSTOMER][NEUTRAL] It's, uh sorry, [PII]. Date of birth is on [PII].
[AGENT][NEUTRAL] State of service and bill charges?
[CUSTOMER][NEUTRAL] The data services on.
[CUSTOMER][NEUTRAL] [PII], with the amount of $13,715 even.
[AGENT][NEUTRAL] was received 13125. Process [PII].
[AGENT][NEUTRAL] And we need the copy of the explanation of benefits, primary.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh,
[CUSTOMER][NEUTRAL] Yeah, OK. For this two, you, you didn't it, right? Because you already submitted to the fax number for this too.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] For this claim, we have already submitted the primary UB uh you didn't receive, right?
[AGENT][NEGATIVE] No, we have not received it.
[CUSTOMER][NEUTRAL] Yeah, OK. Uh, can you double check the claim number as 355.
[CUSTOMER][NEUTRAL] 891 7. Is that right?
[AGENT][POSITIVE] Yes, that's right.
[CUSTOMER][NEUTRAL] Yeah, I guess it was that that I know.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Just a moment. I have another claim on file.
[AGENT][NEUTRAL] Uh, claim for a different patient.
[CUSTOMER][NEUTRAL] Yeah, it's for the.
[AGENT][NEUTRAL] Policy number?
[CUSTOMER][NEUTRAL] Yeah, it's 018.
[CUSTOMER][NEUTRAL] 506
[CUSTOMER][NEUTRAL] 35.
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] [PII], sorry, [PII].
[CUSTOMER][NEUTRAL] Date of birth is on [PII].
[AGENT][NEUTRAL] State of service and bill charges?
[CUSTOMER][NEUTRAL] It's
[CUSTOMER][NEUTRAL] [PII] at the amount that's $12,536 even.
[AGENT][NEUTRAL] Claim was received on [PII]. Process 43-2025.
[AGENT][NEUTRAL] We received the primary explanation of benefits, but it does not list the amounts applied to deductible, co-pay or co-insurance. We need a detailed explanation of benefits.
[CUSTOMER][NEUTRAL] Yeah, I definitely was that uh.
[AGENT][NEUTRAL] Sorry?
[CUSTOMER][NEUTRAL] And uh
[CUSTOMER][NEUTRAL] Yeah, we will send that again.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] And yeah, I guess definitely that getting the colors for this.
[AGENT][NEUTRAL] All reference is my name, [PII], first initial to last name, [PII], and today's date.
[CUSTOMER][NEUTRAL] Yeah, I guess for us.
[AGENT][POSITIVE] Thanks for calling APL. I hope you have a good day. Bye bye.
[CUSTOMER][POSITIVE] Alright. Have a good day, bye.