AccountId: 011433970860
ContactId: 1de9bf86-11c6-42b4-8629-a734e8b59f69
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 549369 ms
Total Talk Time (AGENT): 116659 ms
Total Talk Time (CUSTOMER): 174316 ms
Interruptions: 2
Overall Sentiment: AGENT=1.1, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/24/1de9bf86-11c6-42b4-8629-a734e8b59f69_20250124T20:15_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey, [PII]. My name is [PII] calling from provider's office, checking on claim status and how are you doing today?
[AGENT][POSITIVE] I'm good. How are you, [PII]?
[CUSTOMER][POSITIVE] Doing pretty well, thank you for asking. Could you please spell your name for documentation purpose?
[AGENT][NEUTRAL] Um, it's spelled [PII] and my last initial is [PII].
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] No problem. Could I please get a callback number just in case we're disconnected?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Which is [PII].
[AGENT][NEUTRAL] Thank you. Now I need the policy number, please.
[CUSTOMER][NEUTRAL] 0, sorry, it's 02250224.
[AGENT][NEUTRAL] Please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Under [PII] with rid of birth [PII].
[AGENT][POSITIVE] OK, thank you and
[AGENT][NEUTRAL] What's the date of service and bill charges on the claim you're calling about? You're calling for claim status, right?
[CUSTOMER][NEUTRAL] Yes, 75 of 2024, which is 75 2024 for $3,0045 even $3045 even.
[AGENT][NEUTRAL] OK, one moment, please.
[CUSTOMER][NEUTRAL] I'm on your portal. I just need the, when did you receive the claim and everything if I found a copy of you, that's very fine.
[AGENT][NEUTRAL] OK, I'm showing that we received this claim on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The claim was processed on [PII].
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The claim number is 3, 3,493,720.
[CUSTOMER][NEUTRAL] Claim number, please? Uh-huh. Thank you.
[AGENT][NEUTRAL] And the claim denied because the benefit maximum was reached on a previous claim.
[CUSTOMER][NEUTRAL] I was unable to find the claim. I don't know the reason I'm on your portal itself. The patient's date of birth is [PII], but the patient's first name is [PII].
[CUSTOMER][NEUTRAL] And the claim number which you provided is 3,493,720, right?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] So, I was unable to pull the copy of COB. OK, help me out, maximum visit, sir, has been exhausted or maximum dollar amount has been exhausted?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] I'm asking you which one has been exhausted? Visits or dollar amount?
[AGENT][NEUTRAL] The dollar amount has been exhausted. We cover up to $500. Mhm.
[CUSTOMER][NEUTRAL] Uh, what is the
[CUSTOMER][NEUTRAL] Per day per month?
[AGENT][NEUTRAL] Per occurrence, per every 3 months.
[CUSTOMER][NEUTRAL] For every 3 months.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Uh, OK. Could you please help me out when was the last service made by this patient on?
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] It was done on [PII].
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]. Uh-huh.
[AGENT][NEUTRAL] Yes, yes.
[CUSTOMER][NEUTRAL] OK. Could you do me a small favor, EB, as you, as I'm unable to pull the copy of EOB from your portal, could you please send a copy of EOB to the remaining balance amount bill to patient?
[AGENT][NEUTRAL] Yes, I can fax it to you. What's your fax number, please?
[CUSTOMER][POSITIVE] Uh, that's, that's really nice and kind of you. The fax number which is [PII]. Attention to my name, [PII]
[AGENT][NEUTRAL] OK. So that's attention, [PII] [PII]. OK, you should receive it in about 10 minutes. Is there anything else that I can assist you with?
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yes, I do, I do have a few more claims.
[AGENT][NEUTRAL] OK, one moment. Let me get this faxed to you.
[CUSTOMER][NEUTRAL] Uh huh.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] The call reference number for the whole call would be the same, right?
[AGENT][NEUTRAL] Yes, it'll be my name and today's date.
[CUSTOMER][NEUTRAL] You said your name is?
[AGENT][NEUTRAL] It's [PII], uh-huh, it's.
[CUSTOMER][NEUTRAL] [PII] and first uh-huh and first initial two last names?
[AGENT][NEUTRAL] It's [PII].
[CUSTOMER][POSITIVE] Thank you, with today's test 1024 20, so [PII]. Thank you for that.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] No problem.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] And the first, after finish upping your documentation of forwarding the copy of.
[AGENT][NEUTRAL] Yes, one moment. I'm looking for this EOB to get it faxed to you, one moment.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Hello.
[AGENT][POSITIVE] Yes, I'm still here. I'm ready for the next policy number.
[CUSTOMER][NEUTRAL] questions.
[CUSTOMER][NEUTRAL] Yeah, so, OK.
[CUSTOMER][NEUTRAL] Are you, oh, I thought you are in mute and you're, you're sending my copy of your bill. The next number ID number which is 02473158.
[AGENT][NEUTRAL] OK. Please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] The patient's name is [PII], with the date of birth [PII].
[AGENT][NEUTRAL] OK, and the date of service and bill charges on the claim, please.
[AGENT][NEUTRAL] Hello.
[AGENT][NEUTRAL] Hello, [PII], are you still there?
[AGENT][NEUTRAL] Hello.
[AGENT][NEUTRAL] Hello.