AccountId: 011433970860
ContactId: 2b86b62e-352d-40dc-831b-1307c2c1b929
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 279760 ms
Total Talk Time (AGENT): 126037 ms
Total Talk Time (CUSTOMER): 91292 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/25/2b86b62e-352d-40dc-831b-1307c2c1b929_20250225T15:34_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh hello, my name is [PII]. It's [PII] Last name is [PII]. I'm calling from provider office. Could you give me a status on uh one claim?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, and can you needing claim status for one claim, is that correct?
[CUSTOMER][NEUTRAL] Yeah, one game only.
[AGENT][POSITIVE] Yes, I can help you with that. And I, what is a good call back number for you please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] That was [PII]. Is that correct?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK, thank you and um what is um the member's policy number? I can't help you with claim status.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Yeah, just a second. Uh member's policy number is
[AGENT][NEUTRAL] Sure
[CUSTOMER][NEUTRAL] 02462880.
[AGENT][POSITIVE] Thank you, one moment please.
[CUSTOMER][NEUTRAL] Yeah, sure.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] And [PII], any information that I do provide for you today will be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] Patient name is [PII]. It's [PII] [PII] and it's last name is [PII] And it's date of birth is [PII].
[AGENT][NEUTRAL] OK, and what is the date of service and total bill amount for her, please?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And the bill amount is 9,235 dollars.54 cents.
[AGENT][POSITIVE] Thank you one moment.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, and [PII], this claim was received. And one moment. The received date was [PII].
[CUSTOMER][NEUTRAL] 7.
[AGENT][NEUTRAL] It was processed and denied on [PII].
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] The claim number is 3507084.
[CUSTOMER][NEUTRAL] Hm.
[AGENT][NEUTRAL] And the reason for the denial states to please provide copies of the primary insurance company's explanation of benefits.
[CUSTOMER][NEUTRAL] Primary OB, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Uh, OK. And, uh, hm, could you, uh, could you give me a mailing address?
[CUSTOMER][NEUTRAL] So that I can
[AGENT][NEUTRAL] The mailing address would be the same as for claims [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And the zip code is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII] OK.
[CUSTOMER][NEUTRAL] Mm, could you give me a call reference number?
[AGENT][NEUTRAL] Uh, yes, and first, um, I keep, once the claim has been processed with APL or if you need a copy of this explanation of benefits, you can go to our portal to print that and our portal website is secured.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And the call reference number for our call today is my name and today's date.
[CUSTOMER][NEUTRAL] Could you spell your name?
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] First initial to last name [PII].
[CUSTOMER][POSITIVE] OK, thank you so much.
[AGENT][POSITIVE] You're very welcome. And is there anything else that I can help you with today?
[CUSTOMER][NEUTRAL] Uh, no, thank you.
[AGENT][POSITIVE] OK, well then, thank you again for calling APL and Keat. I hope you have a great day.
[CUSTOMER][POSITIVE] Mm thank you.
[AGENT][NEUTRAL] Mhm. Bye-bye.
[CUSTOMER][NEUTRAL] Bye bye.