AccountId: 011433970860
ContactId: 3060af03-d417-493d-8dd0-baa2cd5296c2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 211990 ms
Total Talk Time (AGENT): 74407 ms
Total Talk Time (CUSTOMER): 72294 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/03/3060af03-d417-493d-8dd0-baa2cd5296c2_20250603T13:09_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Good morning, [PII]. My name is [PII]. I was calling to um find out how claim was processed.
[AGENT][NEUTRAL] How a claim was processed?
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, cause I don't show a payment.
[AGENT][NEUTRAL] Oh, you just want the claim status.
[CUSTOMER][NEUTRAL] Yes, I, I have the claim number and I have, um, it looks like an EOB in front of me, but there's no payment, so I just want to know what happened with the payment.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Sure. OK, well, I can help you with the claim, and [PII]. May I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Uh, it's [PII].
[AGENT][NEUTRAL] Thank you. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] It is 02455.
[CUSTOMER][NEUTRAL] 09
[CUSTOMER][NEUTRAL] 3.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][POSITIVE] Welcome, thank you.
[AGENT][NEUTRAL] You're welcome. And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Um, [PII].
[CUSTOMER][NEUTRAL] And date of birth I have is [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And may I have the date of service and the total bill for the claim?
[CUSTOMER][NEUTRAL] Uh, the service was.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And the total charges was $5,573.97.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] And can you verify the name of the provider's office on the on the claim?
[CUSTOMER][NEUTRAL] Uh yes, it's Emery.
[CUSTOMER][NEUTRAL] University Hospital.
[AGENT][NEUTRAL] Alright, so I'm showing that the claim was received on [PII].
[AGENT][NEUTRAL] The claim number is 357.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 4259
[AGENT][NEUTRAL] And on [PII], the claim was denied requesting the explanation of benefits from primary insurance.
[CUSTOMER][NEUTRAL] OK, so you are secondary.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, are you showing who the primary is?
[AGENT][NEUTRAL] Um, let me check, hold on one moment.
[AGENT][NEUTRAL] Um, it says Allstate [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And you don't have the ID number, do you?
[AGENT][NEUTRAL] No, it doesn't list the ID number.
[CUSTOMER][NEUTRAL] OK, and you say I'm sorry, you said your name again is?
[AGENT][NEUTRAL] My name is [PII]. First initial to my last name is [PII].
[CUSTOMER][NEUTRAL] OK, and is there a reference number for our call today, [PII]?
[AGENT][NEUTRAL] So there's no call reference number, but you can use my name in today's date.
[CUSTOMER][POSITIVE] OK awesome thank you so much [PII] for your help today.
[AGENT][POSITIVE] You're welcome, [PII]. Was there anything else I can help you with today?
[CUSTOMER][POSITIVE] No, that's it. Have a good day.
[AGENT][POSITIVE] Alright, thanks for calling APL. You too. Bye-bye.
[CUSTOMER][NEUTRAL] Bye bye.