AccountId: 011433970860
ContactId: 072478a6-a45f-4144-b92c-b1055d40dae3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 416649 ms
Total Talk Time (AGENT): 143244 ms
Total Talk Time (CUSTOMER): 81696 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/16/072478a6-a45f-4144-b92c-b1055d40dae3_20250516T20:04_UTC.wav
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[AGENT][NEUTRAL] No, this is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi this is [PII] calling from ma'am, can you hear me?
[AGENT][NEUTRAL] Hello?
[AGENT][NEUTRAL] Hello.
[AGENT][NEUTRAL] I hear a lot of background noise.
[CUSTOMER][NEUTRAL] Right
[CUSTOMER][NEUTRAL] Can you hear me now? Are you able to hear me?
[AGENT][POSITIVE] That's a little better.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Yes ma'am. Hi, this is [PII] calling from Pro office to check on a claim status.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, [PII], you have one claim to check status on, is that correct?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][POSITIVE] Yes, I can help you with that. And [PII], what is your callback number?
[CUSTOMER][NEUTRAL] My callback number is [PII] and that is a direct line.
[AGENT][NEUTRAL] Thank you. And what is the member's policy number, [PII]?
[CUSTOMER][NEUTRAL] Member ID will be?
[CUSTOMER][NEUTRAL] 01897865
[AGENT][POSITIVE] Thank you one moment please.
[AGENT][NEUTRAL] And any information, [PII] that I do provide for you today would be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth?
[CUSTOMER][NEUTRAL] Member's name will be [PII] and date of birth is [PII].
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] And how do you spell your name, ma'am?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Mhm thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] And what is the date of service and total bill amount, please?
[CUSTOMER][NEUTRAL] Day of service will be [PII] and the charge amount is $431 even.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And what is the facility name?
[CUSTOMER][NEUTRAL] Urology of Saint Louis.
[AGENT][NEUTRAL] OK, so this claim was received.
[AGENT][NEUTRAL] The received date on the claim was [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It was processed on [PII].
[AGENT][NEUTRAL] The claim number is 35.
[CUSTOMER][NEUTRAL] Ma'am, but you said it was received 828, but you said process 35.
[AGENT][NEUTRAL] I said the claim was received.
[AGENT][NEUTRAL] Let me go back to that screen. I said that it was received on [PII] and it was processed on 35.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The claim number is 3571264.
[AGENT][NEUTRAL] There was a benefit paid in the amount of $75.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] That was on single check.
[CUSTOMER][NEUTRAL] Can I get the payment date?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And that check did clear on [PII]?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And the remark on this claim, I can give you the remarks. One moment.
[AGENT][NEUTRAL] And for code 36415, that was denied because it states insured's major medical coverage provided full benefits.
[CUSTOMER][NEUTRAL] OK. Could you send a copy of your, to my fax?
[AGENT][NEUTRAL] You can actually print it, you can print it yourself, [PII], if you go to our portal now that you have the claim number at [PII].
[CUSTOMER][NEUTRAL] Ma'am, but uh
[CUSTOMER][NEUTRAL] So be able to send to my fax?
[AGENT][NEUTRAL] Are you not able to print?
[CUSTOMER][NEUTRAL] If you have access.
[CUSTOMER][NEUTRAL] No, ma'am, that's why I'm asking.
[AGENT][NEUTRAL] Just a moment for me to get that information pulled up.
[AGENT][NEUTRAL] And what is your fax number, [PII]?
[CUSTOMER][NEUTRAL] [PII]. [PII] you can use my name.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And again, you said the fax number is [PII]. Is that correct?
[CUSTOMER][NEUTRAL] Yes, ma'am. That's fine.
[AGENT][NEUTRAL] OK, so that has been faxed to you, [PII]. So provided that you're able to receive that, you should be receiving that very soon.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] OK. You're welcome. And is there anything else I could help you with today?
[CUSTOMER][NEUTRAL] And can I get the call?
[AGENT][NEUTRAL] Yes, ma'am, you would use my name along with today's date.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're very welcome, sir.
[CUSTOMER][POSITIVE] Thank you, ma'am. Have a great day and happy weekend.
[AGENT][POSITIVE] I hope you do too, and thank you again for calling APL.
[CUSTOMER][NEUTRAL] Goodbye.
[CUSTOMER][POSITIVE] Thank you, ma'am.
[AGENT][POSITIVE] Bye-bye. You're welcome. Bye-bye.