AccountId: 011433970860
ContactId: 2138b3ef-e35f-45ae-a9d5-af10c1140b2b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 294750 ms
Total Talk Time (AGENT): 116604 ms
Total Talk Time (CUSTOMER): 68070 ms
Interruptions: 1
Overall Sentiment: AGENT=0, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/12/2138b3ef-e35f-45ae-a9d5-af10c1140b2b_20250612T15:56_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], this is [PII]. I'm calling on behalf of a provider and I want to get a claim status.
[AGENT][NEUTRAL] OK, I could check on a claim for you. uh, I'm sorry, what did you say your name was?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, and [PII], can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] Yeah it's [PII].
[AGENT][NEUTRAL] Thank you and then do you have that policy number?
[CUSTOMER][NEUTRAL] The policy number is 01828767.
[AGENT][NEUTRAL] OK and then what was the name and date of birth for the member please?
[CUSTOMER][NEUTRAL] Uh, date of birth is [PII].
[AGENT][NEUTRAL] And what was the member's name please?
[CUSTOMER][NEUTRAL] And the patient
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you so much for verifying that. What was the date of service for this claim?
[CUSTOMER][NEUTRAL] So the date of service is
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] I'm sorry, that was [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, what was that bill amount please?
[CUSTOMER][NEUTRAL] It's 4 sorry, it's $848 848.
[AGENT][NEUTRAL] OK thank you one moment.
[AGENT][NEUTRAL] OK, uh, so we did receive this claim. It does look like uh the explanation of benefits from the major medical was not legible, so we would need that, uh, resubmitted a legible copy of the major medicals EOB.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] So it's mean uh you guys need primary insurance EOB.
[AGENT][NEGATIVE] We did receive the EOB. however, it was not legible we could not read it.
[AGENT][NEUTRAL] So we would need a clearer, more legible copy of the major medicals EOB.
[CUSTOMER][NEUTRAL] OK, got it. Can I get the claim number?
[AGENT][NEUTRAL] Yes, that is 35.
[AGENT][NEUTRAL] 99.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 315.
[CUSTOMER][NEUTRAL] OK, and what the claim received it?
[AGENT][NEUTRAL] Uh, one moment, let me get that.
[AGENT][NEUTRAL] This claim was received [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And it was processed on [PII].
[CUSTOMER][NEUTRAL] OK, so how can we submit the uh primary EOB?
[AGENT][NEUTRAL] Sure, I've got a mailing address and a fax number I can give you.
[CUSTOMER][NEUTRAL] OK, what's the mailing address?
[AGENT][NEUTRAL] That is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And that is in [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Zip code is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, and what's the fax number?
[AGENT][NEUTRAL] That is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK. And uh what will be the attention?
[AGENT][NEUTRAL] Claims department.
[CUSTOMER][NEUTRAL] Claims department. OK, got it.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Alright, was there anything else I could help you with?
[CUSTOMER][NEUTRAL] Can you please spell your name for me?
[AGENT][POSITIVE] Oh sure, it's uh [PII] I'm sorry?
[CUSTOMER][NEUTRAL] Mm, yeah, I also want to not.
[CUSTOMER][NEUTRAL] Uh, I also want to know the time if I limit for appeal.
[AGENT][NEGATIVE] Oh, there is no sure there's no timely filing limit.
[CUSTOMER][NEUTRAL] And uh for you
[CUSTOMER][NEUTRAL] OK, [PII], what is your uh first number for this call?
[AGENT][NEUTRAL] Reference number would just be my first name, last initial, and today's date. Uh, so my last initial is A.
[CUSTOMER][POSITIVE] OK, thank you so much, [PII]. Hope you have a wonderful day.
[AGENT][POSITIVE] Of course, thanks for calling APL you too thank you bye bye.
[CUSTOMER][NEUTRAL] Bye bye.