AccountId: 011433970860
ContactId: 0ffcb894-d205-48ad-8a5c-ce94d2da7616
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 258279 ms
Total Talk Time (AGENT): 98507 ms
Total Talk Time (CUSTOMER): 97404 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/12/0ffcb894-d205-48ad-8a5c-ce94d2da7616_20250612T18:21_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey, hi, uh, very good good good morning. This is [PII] from Billing Department of Georgia Family Care. This is a call regarding one of my patients, uh, claim. So before we start, can you please spell out your good name for me?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] And last name initial [PII].
[AGENT][NEUTRAL] Um, [PII]
[CUSTOMER][POSITIVE] So sweet of you. Thank you.
[AGENT][NEUTRAL] Can I get a good callback number in case we get disconnected?
[CUSTOMER][NEUTRAL] Yeah, sure. It's [PII].
[CUSTOMER][NEUTRAL] [PII] option 5.
[AGENT][NEUTRAL] And what's the policy number?
[CUSTOMER][NEUTRAL] The policy number is 0255.
[CUSTOMER][NEUTRAL] 9891.
[AGENT][NEUTRAL] Alright, give me just a moment to look that up, and you're winning claim status correct?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][POSITIVE] Yeah, that's right.
[AGENT][NEUTRAL] Can you verify the patient's name and date of birth for me, please?
[CUSTOMER][NEUTRAL] Yeah, the patient name is [PII] and the date of birth is [PII].
[AGENT][POSITIVE] Thank you so much for verifying that with me.
[AGENT][NEUTRAL] Do you have the claim number or date of service?
[CUSTOMER][NEUTRAL] Uh, I have the data services, uh, [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, I do have the claim number as well. I have the half explanation of benefit.
[CUSTOMER][NEUTRAL] Uh, the claim number is 3609278.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right, it looks like that claim was denied.
[AGENT][NEUTRAL] Um, give me just one moment.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] It looks like we're waiting for information to confirm eligibility from benefits and a card. Um, once they have that information, we will continue to process the claim. Uh, if you have any questions with, uh, their process, oh, go ahead.
[CUSTOMER][NEUTRAL] So,
[CUSTOMER][NEUTRAL] Yeah, so who gonna provide you that benefit information?
[AGENT][NEUTRAL] Um, it will be from benefits on a card.
[AGENT][NEUTRAL] They will provide it with us. Um, your, your portion should be complete. Now we're just waiting for uh benefits in the card to provide their information.
[CUSTOMER][NEUTRAL] OK, so how much time it will take?
[AGENT][NEUTRAL] Um
[AGENT][NEUTRAL] Should be within 7 to 10 business days.
[AGENT][NEUTRAL] Uh, let me see when we got that out to them.
[CUSTOMER][NEUTRAL] OK, more 7 to 2 business days.
[AGENT][NEUTRAL] And it looks like we sent out that information to them on uh [PII].
[CUSTOMER][NEUTRAL] Uh, which information? So sorry.
[AGENT][NEUTRAL] Uh, we sent, uh, benefits on a card, uh, a request to give uh eligibility on [PII].
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] So we're still waiting information for them. Mhm.
[CUSTOMER][NEUTRAL] OK. So, uh,
[CUSTOMER][NEUTRAL] It will take more 7 to 10 business days, right?
[AGENT][POSITIVE] Uh, correct.
[CUSTOMER][POSITIVE] OK, that's great. Is there any call reference number for this?
[AGENT][NEUTRAL] So we don't have call reference numbers, but you can use my name and last initial in today's date.
[CUSTOMER][NEUTRAL] And can you help me with the time in your system? What is the time in your system?
[AGENT][NEUTRAL] Uh, we are central, so it's [PII]
[CUSTOMER][NEUTRAL] So.
[CUSTOMER][POSITIVE] CST Central Standard Time. OK, that's great. Thank you so much, [PII], for that information. That's all done. Thank you. Have a great day to you.
[AGENT][NEUTRAL] Yes.
[AGENT][POSITIVE] Thank you for calling APL. I hope you have a great day.
[CUSTOMER][NEUTRAL] See you, bye-bye.
[AGENT][NEUTRAL] OK.