AccountId: 011433970860
ContactId: 10743733-43e6-4ca2-acfb-83c4dcb35e5c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 511260 ms
Total Talk Time (AGENT): 193397 ms
Total Talk Time (CUSTOMER): 300409 ms
Interruptions: 15
Overall Sentiment: AGENT=0.4, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/31/10743733-43e6-4ca2-acfb-83c4dcb35e5c_20250131T14:34_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yes, uh, my name is I'm calling from.
[AGENT][NEUTRAL] Oh, I'm sorry, it's very hard to hear you. You sound very far away.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Right now I can.
[CUSTOMER][NEUTRAL] I still can't hear you. You can hear me?
[AGENT][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Hello.
[AGENT][POSITIVE] Yes, it's getting better. Hello.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, I can hear you now. Um, can you repeat everything you said? I didn't, I didn't hear you.
[CUSTOMER][NEUTRAL] Yeah, sure, uh, my name is [PII]. I'm calling from the provider office. I check on the general claim status.
[CUSTOMER][NEUTRAL] So its tactics politely of you.
[AGENT][NEUTRAL] OK, and I didn't catch your name. Can you say it again, please?
[AGENT][POSITIVE] OK, and I'll be more than happy to help you with the claim status. May I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] O.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you for that. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Just a number right now is 2460355.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] [PII] and uh date of birth [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And may I have the date of service for the claim you want me to check on?
[CUSTOMER][NEUTRAL] that
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Well you.
[AGENT][NEUTRAL] I'm sorry, it, it went back low again.
[CUSTOMER][NEUTRAL] So it's uh [PII].
[CUSTOMER][NEUTRAL] You don't I don't, don't disturb the total charge amount $748.
[AGENT][NEUTRAL] OK, and the total bill amount?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEGATIVE] Smiza.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] I believe I just located it. Yeah, this is, you said $748?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, hold on one moment, OK?
[CUSTOMER][NEUTRAL] Mhm. You are on hold.
[AGENT][NEGATIVE] This is 7:27. Lord, I hate it when it's like this, OK.
[AGENT][NEUTRAL] 979.
[AGENT][NEUTRAL] OK, well, let's just check the other one.
[AGENT][NEUTRAL] 979.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] 3545904.
[AGENT][NEUTRAL] OK, that ain't it.
[AGENT][NEUTRAL] 574 574.
[AGENT][NEUTRAL] That ain't it.
[AGENT][NEUTRAL] So this is 5:17 and this is 21.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Uh, um, I'll confirm the tax ID.
[AGENT][NEGATIVE] He was talking so fast. I didn't even get it. I couldn't understand why they heard me ask so.
[AGENT][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][POSITIVE] Hello. Thank you so much for holding. I apologize for that wait. Um, what is the tax ID for your provider?
[CUSTOMER][NEUTRAL] 5590.
[CUSTOMER][NEUTRAL] 791028.
[AGENT][NEUTRAL] Thank you for that. The reason I'm asking is because we have 3 claims here for your date of service.
[CUSTOMER][NEUTRAL] Mhm, yeah, $21 right? $727 right?
[AGENT][NEUTRAL] The only claim close to yours is a different total bill, but it's the same tax ID, so it is your provider, but it's $727.
[AGENT][NEUTRAL] I'm sorry?
[AGENT][NEUTRAL] Right, but you said the total bill is 748. Is this 727 correct?
[CUSTOMER][NEUTRAL] Yeah, yes, yes, that is the only so.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, so that claim was received on [PII].
[CUSTOMER][NEUTRAL] which unit for.
[AGENT][NEUTRAL] The claim number is 354-4979.
[CUSTOMER][NEUTRAL] That.
[AGENT][NEUTRAL] And on [PII], the claim was denied?
[AGENT][NEUTRAL] Because the service is not is not covered when performed in a doctor's office or clinic.
[CUSTOMER][NEUTRAL] Under the patient plan, right?
[AGENT][NEUTRAL] I'm sorry.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] So it was the denied has not covered under the patient.
[AGENT][POSITIVE] Right, that's correct.
[CUSTOMER][NEUTRAL] And uh when the which plan is you have the I know the patient plan which plan it is mhm.
[AGENT][NEUTRAL] I'm sorry.
[AGENT][NEUTRAL] This is a Medlink supplemental insurance?
[CUSTOMER][NEUTRAL] Mid line, right? OK, it will be able to send you.
[AGENT][NEUTRAL] I'm sorry?
[AGENT][NEUTRAL] OK, it's really hard to hear your background is louder than you. Can you repeat that one more time? I'm sorry.
[CUSTOMER][NEUTRAL] It's um, will you able to send me the copy of the with the fax.
[AGENT][NEUTRAL] Oh, sure, I can see the um explanation of benefits through fax. May I have a good fax number?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] No, I'll repeat the fax number again. It's [PII].
[AGENT][NEUTRAL] So
[AGENT][NEUTRAL] [PII], OK. Thank you. And does it need to be um to what attention?
[CUSTOMER][NEUTRAL] So, uh, attention to put, uh, account number patient account number.
[AGENT][NEUTRAL] So [PII]?
[CUSTOMER][POSITIVE] Yes, that is good.
[CUSTOMER][NEUTRAL] Maybe.
[AGENT][NEUTRAL] OK, so I'll go ahead and fax the explanation of benefits over to you now. Was there anything else I could assist you with today?
[CUSTOMER][NEUTRAL] And how much time it will take to meet.
[AGENT][POSITIVE] Um, we usually say for a fact to give it at least an hour. If you have not received it by the end of day today, you can definitely give us a call back and we'll be more than happy to resend it for you.
[CUSTOMER][POSITIVE] Thank you so much for that information and uh will you be able to help me with that?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] On reference number.
[AGENT][NEUTRAL] So there's no call reference number, but you can use my name in today's date. That's [PII], first initial to my last name is [PII].
[CUSTOMER][NEGATIVE] It's not.
[CUSTOMER][POSITIVE] Thank you so much yeah.
[AGENT][NEUTRAL] Alright, was there
[CUSTOMER][NEUTRAL] Bye bye.