AccountId: 011433970860
ContactId: 16683671-cba6-4621-b027-0a35493e718d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 353380 ms
Total Talk Time (AGENT): 76493 ms
Total Talk Time (CUSTOMER): 162448 ms
Interruptions: 1
Overall Sentiment: AGENT=-0.1, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/29/16683671-cba6-4621-b027-0a35493e718d_20250529T14:03_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII] calling from provider's office to check on a claim.
[AGENT][NEUTRAL] I can help you with claim status, [PII]. Can I get a good call back number in case we get disconnected?
[CUSTOMER][NEUTRAL] Yeah, it is [PII].
[AGENT][NEUTRAL] And do you have the policy number?
[CUSTOMER][NEUTRAL] Um, yes, I do. So it is, uh, it is, uh,
[CUSTOMER][NEUTRAL] 01009699.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] And can I get you to verify the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Uh, yeah, so the patient name is uh [PII], and the date of birth was uh [PII].
[AGENT][POSITIVE] OK, thank you so much for verifying that.
[AGENT][NEUTRAL] Do you have the
[AGENT][NEUTRAL] Claim number or date of service?
[CUSTOMER][NEUTRAL] Um, yeah, so I do have a claim number. The claim number is uh 3,454,330. Regarding this, I, I'm just looking for a copy of an EOB through fax.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me see.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] So you know that claim was denied.
[CUSTOMER][NEUTRAL] Sorry, actually, uh, it was paid, right?
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] It was uh cashed on [PII].
[AGENT][NEUTRAL] 3454.
[AGENT][NEUTRAL] 330.
[CUSTOMER][NEUTRAL] 34, yes.
[AGENT][NEGATIVE] I'm showing that is being denied. Let me look.
[AGENT][NEGATIVE] Yeah, that was denied because lab tests aren't covered under this policy.
[CUSTOMER][NEUTRAL] Yeah. Uh there is a follow-up call. We made 3 calls and the rep stated that it was paid. It was paid in the amount of $75.
[AGENT][NEUTRAL] Um, I'm not showing up for this claim number.
[CUSTOMER][NEUTRAL] Actually, just for the bill amount of $229 even only, right? 2 to $9 for 11 of $24.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK. So may I know what's the current status of the claim?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The claim was denied.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, denied for laboratory diagnosis was not covered under the patient's plan, right?
[AGENT][NEUTRAL] Right.
[CUSTOMER][POSITIVE] OK. Thanks for the confirmation. And uh just give me a minute.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK. So for this one also I need uh EOB.
[CUSTOMER][NEUTRAL] So, can I provide you the fax number?
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] Yes, ma'am. What's the fax number?
[CUSTOMER][NEUTRAL] It is [PII]. And uh you can use attention to um S as in Sierra, [PII].
[CUSTOMER][NEUTRAL] And [PII].
[CUSTOMER][NEUTRAL] The [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, can I get that? I have Swappy. Can you give me the last name again?
[CUSTOMER][POSITIVE] Yeah, it is [PII]
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright
[AGENT][NEUTRAL] Give me just a moment and I'll get that faxed over to you.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] One moment while my computer pulls up the EOB.
[CUSTOMER][NEUTRAL] Um, sorry, what's the call reference?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] So.
[AGENT][NEUTRAL] The call reference number we don't have call reference numbers, but you can use my name and last initial in today's date, so [PII].
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah. OK.
[AGENT][NEUTRAL] In today's date.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, so thank you and you have a great day.
[AGENT][POSITIVE] Alright thank you for calling APL have a great day.
[CUSTOMER][NEUTRAL] You too, bye.
[CUSTOMER][POSITIVE] Thank