AccountId: 011433970860
ContactId: 0c03f7af-bb53-44af-bfca-934b0dff842c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 388010 ms
Total Talk Time (AGENT): 89400 ms
Total Talk Time (CUSTOMER): 116655 ms
Interruptions: 1
Overall Sentiment: AGENT=0.6, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/10/0c03f7af-bb53-44af-bfca-934b0dff842c_20250210T17:04_UTC.wav
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[AGENT][NEUTRAL] For calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hey, this is [PII] calling from the provider's office to check on a claim status.
[AGENT][NEUTRAL] OK, you said your name is [PII]?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Do you
[AGENT][NEUTRAL] Oh, it's [PII]. OK. Spell your name, [PII]. I'm sorry.
[AGENT][NEUTRAL] How do you spell your name?
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] Lima Lima.
[CUSTOMER][NEUTRAL] E as in Echo.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and you said that you're checking claim status?
[CUSTOMER][POSITIVE] Yeah, that's right.
[AGENT][NEUTRAL] OK. What's the policy number?
[CUSTOMER][NEUTRAL] Yeah, before that, I would like to inform you that this call is being recorded for training and quality purposes. Is that fine?
[AGENT][NEUTRAL] That's fine.
[CUSTOMER][NEUTRAL] OK, uh, the policy number is 016349.
[CUSTOMER][NEUTRAL] 12 M as in Mike L as in Lima, number 7.
[AGENT][NEUTRAL] And what's a good callback number in case we're disconnected?
[CUSTOMER][NEUTRAL] It's [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Hello, are you there?
[AGENT][NEUTRAL] I am I'm pulling up the file give me one moment.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] OK, yeah, sure, take your time.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And what is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] It's [PII]. The date of birth is [PII].
[AGENT][NEUTRAL] Thank you, and if you can verify the date of service and the total charge, we can help you with the claim status.
[CUSTOMER][NEUTRAL] Data service is [PII] and the total charge bill is $200 even.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I'm
[AGENT][NEUTRAL] What's the um procedure code on the claim, um, Alan?
[CUSTOMER][NEUTRAL] It's 87635.
[AGENT][NEUTRAL] Is that the only code?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So I do not show a claim for date of service [PII], uh, the amount of 200 with that um procedure code on it you gave me, give me the code again.
[CUSTOMER][NEUTRAL] It's 87635.
[AGENT][NEUTRAL] Yeah, I do not see a claim with that code on it for [PII].
[CUSTOMER][NEUTRAL] OK. I do have a claim number with me.
[AGENT][NEUTRAL] And what is that number?
[CUSTOMER][NEUTRAL] It's 345.
[CUSTOMER][NEUTRAL] 458 7.
[AGENT][NEUTRAL] I see 87631 as the procedure code.
[CUSTOMER][NEUTRAL] 61
[AGENT][NEUTRAL] Under that claim number you gave me?
[CUSTOMER][NEUTRAL] OK, yeah.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] You said 87635, right?
[CUSTOMER][NEUTRAL] Yeah, just a moment, let me double check it.
[CUSTOMER][NEUTRAL] Yeah actually I'm looking for uh.
[CUSTOMER][NEUTRAL] 87635.
[CUSTOMER][NEUTRAL] And both 87635 and 631.
[AGENT][NEUTRAL] OK, so I only have the claim for 87631 and we're needing a copy of the major medical explanation of benefits. Um, what was the charge for the [PII]?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] [PII] charge was for $356.58.
[AGENT][NEUTRAL] OK, we need a copy of the major medical explanation of benefits.
[CUSTOMER][NEUTRAL] Uh, we have sent a copy through uh mail.
[AGENT][NEGATIVE] We've not received it, [PII].
[AGENT][POSITIVE] So we cannot proceed without it.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and what about 87635? You don't have a claim on file? Oh, OK.
[AGENT][POSITIVE] I've not received the claim. Great.
[CUSTOMER][POSITIVE] Uh, OK, fine. Thank you so much for your assistance.
[AGENT][NEUTRAL] Mhm. Anything else?
[CUSTOMER][NEUTRAL] Yeah, I do, I do need the reference number for this.
[AGENT][NEUTRAL] My name in today's state [PII], first initial last name is [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you so much, [PII]. Have a great day ahead. Bye.
[AGENT][POSITIVE] Oh, you're welcome. Thank you for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] Bye-bye.