AccountId: 011433970860
ContactId: 28243dca-512f-47e1-8a52-bf8563bd8636
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 308179 ms
Total Talk Time (AGENT): 112768 ms
Total Talk Time (CUSTOMER): 97904 ms
Interruptions: 0
Overall Sentiment: AGENT=-0.4, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/19/28243dca-512f-47e1-8a52-bf8563bd8636_20250319T15:27_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, I see. This is [PII] calling you from provider office, and I'm looking for the claim status.
[AGENT][NEUTRAL] I'm sure, [PII], I can assist you with claim status. Um, first, I'll need a good callback number just in case we're disconnected.
[CUSTOMER][NEUTRAL] Yeah, sure. It's [PII].
[AGENT][NEUTRAL] OK, thank you. Now, I need the policy number, please.
[CUSTOMER][POSITIVE] OK thank you
[CUSTOMER][NEUTRAL] Yeah, sure.
[CUSTOMER][NEUTRAL] Um, the policy number I'm having here, it's 421.
[CUSTOMER][NEUTRAL] 355.
[AGENT][NEUTRAL] Please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] Patient name is [PII].
[CUSTOMER][NEUTRAL] And the date of birth, [PII].
[AGENT][NEUTRAL] And what's the date of service and bill charges on the claim?
[CUSTOMER][NEUTRAL] And the date of service, I'm looking for 120-2025 and the charge amount is $2,179.
[AGENT][NEUTRAL] OK, one moment, please.
[CUSTOMER][POSITIVE] Take your time.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, thanks for your patience, [PII]. Um, I'm showing that we received that claim on [PII].
[AGENT][NEUTRAL] The claim processed on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And the claim number is 3.
[AGENT][NEUTRAL] 555552.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEGATIVE] And this claim is denied.
[CUSTOMER][NEUTRAL] 35555552
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEGATIVE] And this claim is denying because it's not covered under the policy. The service is not covered under this policy.
[CUSTOMER][POSITIVE] Perfect, perfect. So, can you send me the UB for this one?
[AGENT][NEUTRAL] Um, yes, I can fax you the EOB. What's your fax number?
[CUSTOMER][NEUTRAL] It's 508.
[CUSTOMER][NEUTRAL] 748
[CUSTOMER][NEUTRAL] 5908.
[AGENT][NEUTRAL] OK, so that's attention be [PII].
[CUSTOMER][POSITIVE] Yeah, correct.
[CUSTOMER][NEUTRAL] [PII]. Yes, perfect. Yeah, please put attention to my name. It's [PII]
[AGENT][NEUTRAL] OK. Yes, sir. I just sent it. You should receive it in about 10 minutes. Is there anything else that I can assist you with?
[CUSTOMER][NEUTRAL] Actually, I'm having one more claim with the same patient, but the date of service is different.
[AGENT][NEUTRAL] OK, one moment, please.
[AGENT][NEUTRAL] OK, and the next date of service?
[CUSTOMER][NEUTRAL] Um, it is uh [PII].
[CUSTOMER][NEUTRAL] Total bill amount $344.
[AGENT][NEUTRAL] OK, we received this claim on [PII].
[AGENT][NEUTRAL] It processed on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The claim number is 3555981.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEGATIVE] And it's also denying, mhm, and it's also denying because the service is not um covered under the policy.
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] Oh, the same denier as well. All right. So can you send me the UB as well for this one also with the same fax number?
[AGENT][NEUTRAL] Yes sir.
[AGENT][NEUTRAL] Is there anything else that I can assist you with?
[CUSTOMER][POSITIVE] Thank you so much.
[CUSTOMER][NEUTRAL] Uh, nothing. I'm done. Uh, could you also give me the reference number for our call?
[AGENT][NEUTRAL] Yes, for the reference number, you can use my name in today's date. My name is [PII]. Um it's spelled [PII] Last initial is [PII], and today's date.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Your spell is [PII]
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][POSITIVE] Perfect. Easy. Thank you so much for giving me this information and assisting me today. Bye for now, you have a great day and stay safe. Bye-bye.
[AGENT][NEUTRAL] You do the same, [PII]. Thank you for calling APL. Mm bye.