AccountId: 011433970860
ContactId: 2177cf3e-4e94-4bbb-b150-6e7f98b253ce
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 548169 ms
Total Talk Time (AGENT): 129711 ms
Total Talk Time (CUSTOMER): 125818 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/25/2177cf3e-4e94-4bbb-b150-6e7f98b253ce_20250425T15:35_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from provider office. I'm calling regarding the claim status. Before proceeding, I would like to share this call is recorded for training and quality purpose. Is it OK for you?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] And what was your name? I'm sorry.
[CUSTOMER][POSITIVE] Thank you so much.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And how did you pronounce it? [PII]?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And do you have a phone number I can get in case we get disconnected I can call you back?
[CUSTOMER][NEUTRAL] Sure, [PII] [PII].
[AGENT][NEUTRAL] Do you have a phone number I can get?
[CUSTOMER][NEUTRAL] Sorry, [PII].
[AGENT][NEUTRAL] And do you have the policy number?
[CUSTOMER][NEUTRAL] 02555948.
[AGENT][NEUTRAL] Thank you. Hold on one moment, please.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] And what's the patient's name?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Patient name is [PII]. Date of birth is [PII].
[AGENT][POSITIVE] Thank you, [PII]. And.
[CUSTOMER][NEUTRAL] Can you spell out your name?
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] And you are needing claim status?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] OK, I can help you with that one day the service.
[CUSTOMER][NEUTRAL] [PII] with the total charge, $3500 even.
[AGENT][NEUTRAL] OK, we did get that claim in. We are needing the primary explanation of benefits.
[CUSTOMER][NEUTRAL] OK. I not receive it?
[AGENT][NEUTRAL] I didn't understand what you said.
[CUSTOMER][NEUTRAL] Can you probably receive date of the claim?
[AGENT][NEUTRAL] Hold on one moment.
[AGENT][NEUTRAL] It was received [PII].
[AGENT][NEUTRAL] And was denied [PII].
[AGENT][NEUTRAL] And the claim number is 3593337.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] 359-3337, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] And the call reference number?
[AGENT][NEUTRAL] We do not have call reference numbers. You can use my name in today's date.
[CUSTOMER][NEUTRAL] Uh, OK. And it will be spell out [PII], right?
[AGENT][NEUTRAL] No, ma'am. [PII]
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK. [PII], right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] OK. Thank you so much. Uh, can you help me with one more claim?
[AGENT][NEUTRAL] Hold on just a moment.
[CUSTOMER][NEUTRAL] Sure
[AGENT][NEUTRAL] Is it on the same person or different policy?
[CUSTOMER][NEUTRAL] Different policy.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] OK, what's the next policy number?
[CUSTOMER][NEUTRAL] 1317924
[AGENT][NEUTRAL] 1317924.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And what's the patient's name?
[CUSTOMER][NEUTRAL] [PII]'s date of birth is [PII].
[AGENT][NEUTRAL] Data service.
[CUSTOMER][NEUTRAL] [PII]. The total charge $905 even.
[AGENT][NEUTRAL] Hold on one moment.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] And what was one of the procedure codes on that bill?
[CUSTOMER][NEUTRAL] 7683076856.
[AGENT][NEUTRAL] But that claim was paid.
[AGENT][NEUTRAL] We paid $500.
[CUSTOMER][NEUTRAL] Uh, OK. Can you provide me the payment details?
[AGENT][NEUTRAL] The check number is 203.
[AGENT][NEUTRAL] 4745.
[AGENT][NEUTRAL] Claim number 3579879.
[CUSTOMER][NEUTRAL] OK. And uh for procedure code 76856, which, uh which is not paid.
[AGENT][NEUTRAL] Max was met.
[AGENT][NEUTRAL] Max Mit, all we pay is $500 per occurrence.
[CUSTOMER][NEUTRAL] Sorry?
[CUSTOMER][NEUTRAL] $500.
[AGENT][NEUTRAL] Yes, max payable is 500 per occurrence.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you so much.
[CUSTOMER][POSITIVE] Thank you so much and the for reference the same, right?
[AGENT][NEUTRAL] And what else?
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] Thank you so much. Have a good day.
[AGENT][POSITIVE] Thank you. Thank you, [PII] for calling API. You have a good day as well. Bye-bye.
[CUSTOMER][NEUTRAL] Bye.