AccountId: 011433970860
ContactId: 33aeaa00-02c5-4405-8d0d-4c06ed5de82f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 274559 ms
Total Talk Time (AGENT): 96390 ms
Total Talk Time (CUSTOMER): 80797 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/05/33aeaa00-02c5-4405-8d0d-4c06ed5de82f_20250205T18:53_UTC.wav
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[AGENT][POSITIVE] Thank you for calling AP Moa. How may I help you?
[CUSTOMER][NEUTRAL] Yes, my name is [PII]. I'm looking for a claim status.
[AGENT][NEUTRAL] And could you spell your next, your um name for me, please?
[CUSTOMER][NEUTRAL] Yeah, it's [PII]. Could you please spell your name?
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] And [PII] you said you're calling for claim status?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And the policy number?
[CUSTOMER][NEUTRAL] It's 02449827.
[AGENT][NEUTRAL] What's a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] Sorry?
[CUSTOMER][NEUTRAL] Oh yeah. It's [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And what is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yeah, first name is [PII] and the last name is [PII] Date of birth is [PII].
[AGENT][NEUTRAL] Alright, thank you for that information and what is the date of service?
[CUSTOMER][NEUTRAL] It's uh [PII], built on [PII].
[AGENT][NEUTRAL] One
[AGENT][NEUTRAL] How much is, what's the total charge?
[CUSTOMER][NEUTRAL] 1050.
[AGENT][NEUTRAL] 1050. OK. Thank you.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Um
[AGENT][NEUTRAL] So the claim was received [PII].
[AGENT][NEUTRAL] Process [PII], and we denied it for a copy of the primary insurance explanation of benefits.
[CUSTOMER][NEUTRAL] OK, can you tell me the primary insurance name?
[AGENT][NEUTRAL] I'm sorry.
[CUSTOMER][NEUTRAL] Primary insurance name?
[AGENT][NEUTRAL] I'm showing Aetna, but you want to check with your patient as well. Are you calling from the doctor's office?
[CUSTOMER][NEUTRAL] Uh, no, uh, from providers.
[AGENT][NEUTRAL] Mhm, you're calling from the provider's office?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So it is Aetna, right?
[AGENT][NEUTRAL] And so do you have the primary insurance information on file for this patient?
[CUSTOMER][POSITIVE] Yes, we want.
[AGENT][NEUTRAL] And who do you show as the primary?
[CUSTOMER][NEUTRAL] Uh, in my system is showing at now.
[AGENT][NEUTRAL] OK. And did you have any other questions?
[CUSTOMER][NEUTRAL] Oh yes, I have. What was the claim number?
[AGENT][NEUTRAL] The claim number is 352-7900.
[CUSTOMER][NEUTRAL] OK, and uh what was the effective and term date?
[AGENT][NEUTRAL] Effective [PII], the policy is active. It's not termed.
[CUSTOMER][NEUTRAL] What was the Aetna member ID?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] What was the Aetna member ID number?
[AGENT][NEUTRAL] It's the number that you gave me.
[AGENT][NEUTRAL] The 244 number?
[CUSTOMER][NEUTRAL] No, I'm asking about.
[CUSTOMER][NEUTRAL] No, I'm asking this, uh, what was the Aetna member ID number?
[AGENT][NEUTRAL] We do not have Aetna's information, ma'am. You would need to contact Aetna.
[CUSTOMER][NEUTRAL] Uh, you have the last UB update details.
[AGENT][NEUTRAL] I'm sorry.
[CUSTOMER][NEUTRAL] Last EOP update date.
[AGENT][NEUTRAL] OK, we do not, we do not update the EOB information so we do not have any information regarding Adna. You would have to contact Edna.
[CUSTOMER][NEUTRAL] OK. And what was the call reference number?
[AGENT][NEUTRAL] It's gonna be my name in today's date, [PII] last [PII] is [PII]. Did you have any other questions I can assist with today?
[CUSTOMER][NEUTRAL] Uh no, thank you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Any other questions I can help with today, [PII]?
[CUSTOMER][NEGATIVE] Uh, no, thanks.
[AGENT][POSITIVE] OK. Thank you for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] Yes.