AccountId: 011433970860
ContactId: 375c5dc2-3450-4b86-9f2b-9c3516c7e483
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 246820 ms
Total Talk Time (AGENT): 117122 ms
Total Talk Time (CUSTOMER): 71943 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/16/375c5dc2-3450-4b86-9f2b-9c3516c7e483_20250516T13:46_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I'm calling from Bell Clinic. I need to see if you've got a couple of claims on file and see what the status is.
[AGENT][POSITIVE] OK, well, I'll be more than happy to help you with the claim status, [PII]. May I have a good contact number in case we're disconnected? And is it all for one patient or they're different members?
[CUSTOMER][NEUTRAL] It's
[CUSTOMER][NEUTRAL] They're both the same patient.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, my phone number is [PII] and that's a direct line with secure voicemail.
[AGENT][NEUTRAL] OK. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] Yes ma'am, it is 02312747.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] [PII]. Date of birth 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 dates of service and total bills?
[CUSTOMER][NEUTRAL] It's 124 2024 for $4,171.
[AGENT][NEUTRAL] And did you have another data service?
[CUSTOMER][NEUTRAL] Yeah, I think it's gonna be the same day, but let me check.
[CUSTOMER][NEUTRAL] It is going to be for the 124 24, but it is $1130.
[AGENT][NEUTRAL] OK, here we go, hold on one moment.
[AGENT][NEUTRAL] And can you verify the name of the provider's office on the claims?
[CUSTOMER][NEUTRAL] Um, it's, it's the Shaw Cancer Center.
[CUSTOMER][NEUTRAL] Or Underval clinic.
[CUSTOMER][NEUTRAL] Either way.
[AGENT][NEUTRAL] OK. Thank you for that. So I'm showing the, so for the first one, hold on one moment.
[AGENT][NEUTRAL] The [PII]. Um, so that claim was received.
[AGENT][NEUTRAL] On April
[AGENT][NEUTRAL] Actually, they both were received on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The $4,171 that claim number is 3592075.
[AGENT][NEUTRAL] The $1130 and that claim number is 3592071.
[AGENT][NEUTRAL] And they both finished processing on [PII].
[AGENT][NEUTRAL] They both were denied requesting the explanation of benefits from primary insurance.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Can I fax those over?
[AGENT][NEUTRAL] Yes, you can. Our fax number, um, let me know when you're ready.
[CUSTOMER][POSITIVE] I'm ready.
[AGENT][NEUTRAL] Alright, it's [PII].
[AGENT][NEUTRAL] 365.
[AGENT][NEUTRAL] 942 3.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And that's attention APL claims department.
[CUSTOMER][NEUTRAL] I think they
[CUSTOMER][NEUTRAL] OK, and what I need to put on there just the uh claim number?
[AGENT][NEUTRAL] Um, you don't have to, um, you can just attach the explanation of benefits and we'll, you can put the claim number on there if you like, um, but once we see the dates on the explanation of benefits, they'll see that's the additional information that was requested.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, alright, all I need is to call reference.
[AGENT][NEUTRAL] So there's no call reference number, but you can use my name in today's date. The first initial to my last name is [PII].
[CUSTOMER][POSITIVE] All right, thank you so much and you have a great day.
[AGENT][NEUTRAL] You also, was there anything else I can help with?
[CUSTOMER][NEUTRAL] No ma'am, that is it.
[AGENT][POSITIVE] All right, thanks for calling APR. Have a great weekend.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye bye.