AccountId: 011433970860
ContactId: 2f1de612-a9b1-4fd7-b772-78d744b57b65
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 276859 ms
Total Talk Time (AGENT): 70295 ms
Total Talk Time (CUSTOMER): 80611 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/17/2f1de612-a9b1-4fd7-b772-78d744b57b65_20250417T19:19_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yeah, good afternoon, [PII]. My name is [PII]. Last name, initial is [PII]. I'm calling from Hover Gelps, uh provider's office to check on claim status.
[AGENT][NEUTRAL] Right. I'm happy to check on a claim. Do you have the patient's policy number?
[CUSTOMER][NEUTRAL] Yes, that is
[CUSTOMER][NEUTRAL] 01699901 M as in Mary, L as in Lima, the number 8.
[AGENT][POSITIVE] Thank you, [PII], and do you have a good callback number?
[CUSTOMER][NEUTRAL] Yes, it's a direct line that is [PII].
[AGENT][NEUTRAL] Thank you. And may I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] It's [PII] and date of birth, [PII].
[AGENT][NEUTRAL] Thank you and then what's the date of service?
[CUSTOMER][NEUTRAL] That is [PII] for $383 even.
[AGENT][NEUTRAL] And you said the date of service again was [PII], is that correct?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Thank you for your patience on that. So it looks like we did receive a claim for this on [PII].
[AGENT][NEUTRAL] Claim was processed and denied [PII]. Office visits are not covered under the member policy.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So the claim was received on [PII] and denied on?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] A
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So the office visits are not covered under the patient's policy, is it?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Can I have the claim number?
[AGENT][NEUTRAL] 358-73887.
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] And also, would you be able to fax me in the copy of the denied EOB?
[AGENT][NEUTRAL] Mhm, what's a good fax number?
[CUSTOMER][NEUTRAL] It is 888.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] I give me one moment. Let me pull that.
[CUSTOMER][NEUTRAL] Give me one moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] I want correct fax number is going to be.
[CUSTOMER][NEUTRAL] It is 888-467.
[CUSTOMER][NEUTRAL] 9575.
[AGENT][NEUTRAL] OK. Should we mark attention to anybody?
[CUSTOMER][NEUTRAL] You can mark attention to my name, [PII]
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] That is on its way. It should be there in about 5 minutes. Is there anything else I can check for you?
[CUSTOMER][NEUTRAL] No, that's all, [PII]. Can I have the reference number for the call?
[AGENT][NEUTRAL] Absolutely. Call references my name with my last initials and today's date. My name is [PII], that's [PII] initials my last name is [PII].
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Thank you, sir. That's all I needed.
[AGENT][POSITIVE] You're welcome have a good day.
[CUSTOMER][NEUTRAL] You too. Bye now.
[AGENT][NEUTRAL] Bye bye.