AccountId: 011433970860
ContactId: 1c2ed33f-d56f-4865-a72e-331925bacbc5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 773539 ms
Total Talk Time (AGENT): 146384 ms
Total Talk Time (CUSTOMER): 122707 ms
Interruptions: 1
Overall Sentiment: AGENT=0.8, CUSTOMER=-2.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/29/1c2ed33f-d56f-4865-a72e-331925bacbc5_20250429T21:04_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII] calling from provider office to check on claim status. Could you please spell your name?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Sure. My name is [PII]. That's [PII]. Last initial is [PII]. And Ms. [PII], may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, my callback number is [PII]. It's direct line call.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I do have 3 claims for the same patient. Could you please help me with that?
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] If it's the same patient, it's OK, sure. Um, and may I have the patient's policy number, Miss?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, sure. Policy number is 02467128.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] What's the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Patient name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] What is the date of service for the first one?
[CUSTOMER][NEUTRAL] Uh, date of service is [PII]. Bill amount is $352 even.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And for future you can check claim status online through our website at [PII] and that's just optional and bear with me, let me pull this ELP.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Hm
[AGENT][NEGATIVE] OK, looks like we received the claim [PII], processed [PII], and the claim was denied. The reason for this denial is that the service is not covered when performed in the doctor's office or clinic.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Uh, service not covered by office, right?
[AGENT][NEUTRAL] Uh, service is not covered when performed in a doctor's office or clinic.
[CUSTOMER][NEUTRAL] OK. Just give me a moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. I could, uh, sir, I could not find the UOB here. Could you please fax the UOB for me?
[AGENT][NEUTRAL] What is the fax number?
[CUSTOMER][NEUTRAL] Just give me a moment. Um.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. My fax number is [PII].
[AGENT][NEUTRAL] OK. And um are you gonna need the
[CUSTOMER][NEUTRAL] Uh, could you please provide me the claim number?
[AGENT][NEUTRAL] Yes. 353-693-6.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And you're gonna need the you'll be for all of them, so I can wait to fax them or you need just this one?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] No, I just need uh next to also. Uh and next to the same date of service.
[AGENT][POSITIVE] OK, so let's go for the next one.
[AGENT][NEUTRAL] The same name?
[CUSTOMER][NEGATIVE] Next date of service is also same, but the bill amount is different. Bill amount is $133 even.
[AGENT][NEUTRAL] OK, so the, the reason is going to be the same one.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And this claim number is
[CUSTOMER][NEUTRAL] OK, same, receive and process date, right?
[AGENT][POSITIVE] Yes, mhm, correct.
[CUSTOMER][NEUTRAL] OK. Claim number?
[AGENT][NEUTRAL] It's um 353-693-1.
[CUSTOMER][NEUTRAL] OK. Next one is same date of service, bill amount is $102 even.
[AGENT][NEUTRAL] OK, so it's also the same do not of reason.
[CUSTOMER][NEUTRAL] Claim number?
[AGENT][NEUTRAL] And the claim number is 353-6951.
[CUSTOMER][NEUTRAL] OK. Uh, when will I get the EOB in fax?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, I can go ahead and send them right now so you get them on a couple of minutes. Do you mind holding for me while I send this out to you?
[CUSTOMER][NEUTRAL] Uh, no, that's it. Could you please provide me the reference number?
[AGENT][NEUTRAL] Um, it's my name in today's day. We don't have reference numbers. Do you mind holding for me while I send this EOB to you, the EOBs to you?
[CUSTOMER][NEUTRAL] Yeah, OK. Uh, to my attention, [PII]
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Oh, so you said it's [PII], [PII]?
[CUSTOMER][NEUTRAL] Yeah, yeah.
[AGENT][NEUTRAL] OK, bear with me, let me go ahead and send this out. OK, one moment.
[CUSTOMER][NEUTRAL] OK. OK.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you for holding and being patient for me, Ms. [PII]. OK, I sent all three. It should be there in a few minutes. Is there anything else I may help you with today?
[CUSTOMER][POSITIVE] Uh, no, that's it for today. Thank you so much for asking me, so have a good day. Bye-bye.
[AGENT][POSITIVE] You as well thank you for calling APL bye bye.