AccountId: 011433970860
ContactId: 24593001-a9fe-46eb-8c70-f852ea434a0d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 245190 ms
Total Talk Time (AGENT): 117061 ms
Total Talk Time (CUSTOMER): 69124 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/05/24593001-a9fe-46eb-8c70-f852ea434a0d_20250305T15:37_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], I'm calling for claim status.
[AGENT][NEUTRAL] OK, yeah, I could check on a claim for you. uh, what was your name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, [PII], can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure, [PII].
[AGENT][NEUTRAL] Thank you and then do you have the policy number?
[CUSTOMER][NEUTRAL] The what?
[AGENT][NEUTRAL] The policy number?
[CUSTOMER][NEUTRAL] Sure, it's um 02361206 ML 8.
[AGENT][NEUTRAL] OK, and then, uh, what was the name and date of birth for the insured please?
[CUSTOMER][NEUTRAL] Uh [PII] [PII].
[AGENT][NEUTRAL] OK, thank you for verifying that [PII] and then what was the date of service for this claim?
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] And the total was.
[CUSTOMER][NEUTRAL] It was 240. Let me see.
[AGENT][NEUTRAL] You said 240?
[CUSTOMER][NEUTRAL] Yeah, let me see.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] OK, thank you one moment please.
[AGENT][NEUTRAL] Was this through, is it, uh, Lady on Figueroa?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, do you believe I've found it give me just a moment.
[AGENT][NEUTRAL] OK, so it looks like there were a few different.
[AGENT][NEUTRAL] Codes, so the first the procedure code 99213 we were unable to pay that benefit as office visits are not covered under this policy. As for the other two, the um 87804, uh, both of those, it looks like we're missing a copy of the primary EOB. So once we have that we'll be able to process those.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, can we, um, fax it to you?
[AGENT][NEUTRAL] Of course, uh, let me know when you're ready for that fax number.
[CUSTOMER][NEUTRAL] 1 2nd.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] What is the fax?
[AGENT][NEUTRAL] That is 877.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 365.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 942 3.
[CUSTOMER][NEUTRAL] Hold on a second, attention.
[AGENT][NEUTRAL] Claims.
[CUSTOMER][NEUTRAL] Or do you have your uh an email that we could email it to you? What would be easier?
[AGENT][NEUTRAL] Uh, not an email, um, but I also have, so the fax number and I've got a payer ID.
[CUSTOMER][NEUTRAL] OK, put the payer ID?
[AGENT][NEUTRAL] That is 60801.
[CUSTOMER][NEUTRAL] 60801.
[AGENT][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] OK, anything else that I have to write on the?
[AGENT][NEUTRAL] No, um, all it's stating is that that's all we're missing is the primary EOB. Um, did you need the claim number?
[CUSTOMER][NEUTRAL] They the patient
[CUSTOMER][POSITIVE] Yes please.
[AGENT][NEUTRAL] OK, that is 356-486-6.
[CUSTOMER][NEUTRAL] Hm
[CUSTOMER][POSITIVE] OK perfect OK.
[AGENT][NEUTRAL] And I could send you a copy of this EOB if you need it.
[CUSTOMER][POSITIVE] Thank you
[CUSTOMER][NEUTRAL] Yes please can you fax it over?
[AGENT][NEUTRAL] Of course, what is that fax number for you?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, I'm going to read that back to make sure I heard that correctly. That was [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, and I would just put this to your attention, [PII].
[CUSTOMER][POSITIVE] Yes please.
[AGENT][POSITIVE] Alrighty, I will get that sent to you now. Should get it within 10-15 minutes. Was there anything else I could help you with?
[CUSTOMER][POSITIVE] No, that's it thank you so much.
[AGENT][POSITIVE] Alright, yeah, thanks for calling ATO. I hope you have a great rest of your day.
[CUSTOMER][POSITIVE] You too thank you so much.
[AGENT][POSITIVE] Thank you bye bye.