AccountId: 011433970860
ContactId: 28d9a513-809d-4211-896a-05e7913a834c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 382829 ms
Total Talk Time (AGENT): 144809 ms
Total Talk Time (CUSTOMER): 101413 ms
Interruptions: 1
Overall Sentiment: AGENT=0.7, CUSTOMER=1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/11/28d9a513-809d-4211-896a-05e7913a834c_20250411T17:55_UTC.wav
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[AGENT][POSITIVE] Thank you for calling APL this is [PII] how may I help you?
[CUSTOMER][NEUTRAL] [PII], Hi. I, uh, my ID is 60801.
[AGENT][NEUTRAL] OK, and um what is your name please, ma'am?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, Ms. [PII]. Can I please get your callback number, ma'am?
[CUSTOMER][NEUTRAL] No, no, no, no, no, no. [PII].
[AGENT][NEUTRAL] [PII]. OK, thank you.
[AGENT][NEUTRAL] And then what is your callback number just in case our call is disconnected?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and um I know you gave me that number [PII] that's our payer ID number. Do you see another number?
[AGENT][NEUTRAL] Um, for your policy number, it starts with maybe a 01 or a 02.
[CUSTOMER][NEUTRAL] 024
[CUSTOMER][NEUTRAL] 733
[CUSTOMER][NEUTRAL] 07 ML 8.
[AGENT][POSITIVE] OK, thank you very much.
[AGENT][NEUTRAL] How can I help you today, [PII]?
[CUSTOMER][NEUTRAL] The date of service was [PII].
[CUSTOMER][NEUTRAL] Could you tell me
[AGENT][NEUTRAL] OK, and are you looking for claim status?
[CUSTOMER][NEUTRAL] One more time, ask me that again.
[AGENT][NEUTRAL] Are you looking for claim status?
[CUSTOMER][NEGATIVE] Well, I'd like to know why it wasn't paid.
[AGENT][NEUTRAL] OK, I can help you with the claims status, Miss [PII]. Um, first, let's verify your policy and pull it in.
[AGENT][NEUTRAL] It's gonna be just a moment. um, can you please verify your date of birth for me?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you ma'am, and then what is your address, phone number and email address that we have on the policy for you?
[CUSTOMER][NEUTRAL] [PII]. The email is [PII].
[AGENT][NEUTRAL] OK and the phone number that you gave me to call you back on is that a good cell phone number?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] OK, thank you, Ms. [PII].
[AGENT][NEUTRAL] And you said the date of service was [PII]. Is that correct?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK. All right. Let me look up.
[AGENT][POSITIVE] That data service for us real quick.
[AGENT][NEUTRAL] Give me just a minute while I pull it up.
[AGENT][NEUTRAL] OK, and what was the amount of the claim?
[CUSTOMER][NEUTRAL] It would, it would be $300. It's for Pembroke Pink imaging.
[AGENT][NEUTRAL] 300 for Pembroke.
[AGENT][NEUTRAL] OK, let me look real quick and see if I can find that claim on file.
[AGENT][NEUTRAL] Do you have the claim number?
[CUSTOMER][NEUTRAL] Um, just the document that I pulled off of your website.
[AGENT][NEUTRAL] OK, and did you see the claim number?
[CUSTOMER][NEUTRAL] 3400155
[AGENT][NEUTRAL] OK, let me look that up real quick for us, Miss [PII].
[AGENT][NEUTRAL] OK, so looking at this claim.
[AGENT][NEGATIVE] I do show that it was denied because we needed the explanation of benefits from the primary insurance carrier.
[AGENT][NEUTRAL] So if the explanation of benefits can be sent in they can reprocess the claim.
[CUSTOMER][NEGATIVE] Don't be farm come come.
[CUSTOMER][NEUTRAL] I need to log in.
[CUSTOMER][NEUTRAL] OK, alright.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Why? I don't know why do you need that? Because you, cause I see that you paid it for the following year and so.
[CUSTOMER][POSITIVE] Anyway, Barb, come on, I can do this. I can do this.
[CUSTOMER][POSITIVE] Um, I can do this.
[AGENT][NEUTRAL] The reason why we need the explanation of benefits is because this is the secondary insurance, so we have to have the explanation of benefits to show what your primary paid so we can process the claim.
[CUSTOMER][POSITIVE] I hear what you're saying. Hopefully I can, I can get to what you need and get it back to you. But trust me, those, those puppies, those puppies? No. We can forget about it. All right. OK. Thanks for the update.
[AGENT][NEUTRAL] Yes, ma'am. Yes.
[AGENT][POSITIVE] You're very welcome. Is there anything else, um, Ms. [PII], that I can help you with before we go?
[CUSTOMER][POSITIVE] No, I probably will end up calling you back, but thanks so much.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Alright, you're very welcome. I hope you have a wonderful weekend and thank you for calling APL.
[CUSTOMER][NEUTRAL] Bye.
[CUSTOMER][NEUTRAL] You too bye bye.