AccountId: 011433970860
ContactId: 15521c60-31cf-4764-873a-1e3ed0b3ef25
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 213649 ms
Total Talk Time (AGENT): 83518 ms
Total Talk Time (CUSTOMER): 76406 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2024/12/30/15521c60-31cf-4764-873a-1e3ed0b3ef25_20241230T19:54_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII] calling you from provider's office speaking on claim status.
[AGENT][POSITIVE] OK, well, I'll be more than happy to help you with the claim status, [PII], and how many claims do you have in total today?
[CUSTOMER][NEUTRAL] Only one claim.
[AGENT][NEUTRAL] Alright, and may I have a good contact number in case we're disconnected and the member's policy number?
[CUSTOMER][NEUTRAL] [PII]. It's the direct line and the member ID is 02462268.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Yeah, the patient's first name is [PII] and the last name is [PII] Date of birth is [PII].
[AGENT][NEUTRAL] Thank you for that. And may I have the date of service and the total bills for the claim?
[CUSTOMER][NEUTRAL] Yeah, date of services.
[CUSTOMER][NEUTRAL] [PII], total charge, $728 even.
[AGENT][NEUTRAL] And that was [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] And can you verify the name of the provider's office on the claim?
[CUSTOMER][NEUTRAL] Holy Cross Medical Group.
[AGENT][NEUTRAL] OK, so I'm just waiting for the claims to pop here.
[AGENT][NEUTRAL] Alright, so I'm showing the claim was received on [PII].
[AGENT][NEUTRAL] That claim number is 353.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] 2338.
[AGENT][NEUTRAL] And on [PII], the claim was denied, requesting an explanation of benefits from primary insurance.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. And the claim was denied on [PII]. I'm right?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK. Just to confirm, the claim number is
[CUSTOMER][NEUTRAL] 353-233-8. I'm right?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, uh, can you please send me a copy of your bit of fax?
[AGENT][NEUTRAL] Yes, what's a good fax number for you?
[CUSTOMER][NEUTRAL] [PII]. Attention to my name, [PII].
[AGENT][NEUTRAL] And that was [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] All right, so I'll go ahead and send this over to you now and again, all the information provided was a verification of benefits, not a guarantee of payment. And [PII], was there anything else I could assist you with today?
[CUSTOMER][NEUTRAL] No. And may I have your name spell, please?
[AGENT][NEUTRAL] Sure, my name is [PII] The first initial to my last name is [PII].
[CUSTOMER][NEUTRAL] OK. And what will be the call reference?
[AGENT][NEUTRAL] Um, there's no call reference number, but you can use my name and today's date.
[CUSTOMER][NEUTRAL] OK. And when I will be receiving the fax?
[AGENT][NEUTRAL] Um, I would say within the hour, I just, I just faxed it over to you.
[CUSTOMER][POSITIVE] OK, sure. Thank you. It was great speaking with you. Have a good day. Bye-bye.
[AGENT][POSITIVE] You also, and thanks for calling APL and Happy New Year.
[CUSTOMER][NEUTRAL] You too.