AccountId: 011433970860
ContactId: 06f96916-26a0-43ad-818a-f1dc6ca9c216
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 190160 ms
Total Talk Time (AGENT): 96275 ms
Total Talk Time (CUSTOMER): 46148 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/15/06f96916-26a0-43ad-818a-f1dc6ca9c216_20250115T16:23_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, I needed to find out, um, regarding a claim.
[CUSTOMER][NEUTRAL] feel that.
[AGENT][NEUTRAL] OK, I could check on a claim for you. uh, so you, you filed a claim and we just need to check to see if it's been received and processed?
[CUSTOMER][NEUTRAL] It's been received, but I don't understand the denial.
[AGENT][NEUTRAL] Oh, I see. OK, yeah, I can get that information for you. What was your name?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] OK, [PII], are you the insured or are you with a provider?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Provider, OK, can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] What is your name?
[AGENT][POSITIVE] Thank you. [PII]
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, and did you have the policy number, [PII]?
[CUSTOMER][NEUTRAL] 01659755
[AGENT][NEUTRAL] OK, one moment please.
[AGENT][NEUTRAL] And what was the name and date of birth for the insured?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] OK, and did you have the uh claim number?
[CUSTOMER][NEUTRAL] Your claim number is 352-9217.
[AGENT][NEUTRAL] OK thank you one moment please.
[CUSTOMER][NEUTRAL] Oh, that's an old too.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, date of service was uh [PII], is that right?
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, so according to the information that we have, so the way that this policy works is this is a secondary medical policy, uh, we do have to have the EOB from their primary insurance showing, uh, what if anything that they did pay, uh, and we don't have that information for this claim. So if we were to get that EOB we could we could continue processing it.
[CUSTOMER][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Oh, because we always send out the EOB.
[AGENT][NEUTRAL] OK, so this information shows that we don't we didn't receive it for this one.
[CUSTOMER][NEUTRAL] OK, where can I send it, send it to?
[AGENT][NEUTRAL] I have an uh mailing address fax number um payer ID what would you like? I can give it all to you if you want.
[CUSTOMER][NEUTRAL] I'll pass it. I'll practice it.
[AGENT][NEUTRAL] OK, yeah, fax number is 877.
[AGENT][NEUTRAL] 365.
[AGENT][NEUTRAL] 942 3.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And can I please have a reference number?
[AGENT][NEUTRAL] Yeah, reference number would just be my first name, last initial, and today's date. Uh, so my last initial is [PII] Was there anything else I could help you with, [PII]?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] That's it thank you.
[AGENT][POSITIVE] Alright, yeah, thanks for calling APL. I hope you have a great rest of your day.
[CUSTOMER][NEUTRAL] Bye bye.
[AGENT][POSITIVE] Thank you