AccountId: 011433970860
ContactId: 37e5dbdb-230b-4957-b8cf-d77a9fe457d9
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 193110 ms
Total Talk Time (AGENT): 67143 ms
Total Talk Time (CUSTOMER): 61098 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=1.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/02/37e5dbdb-230b-4957-b8cf-d77a9fe457d9_20250502T15:12_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII] at Doctor [PII]'s office. I'd like to check on a claim, please.
[AGENT][NEUTRAL] Sure, I can check on a claim for you. [PII], can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And then do you have that policy number?
[CUSTOMER][NEUTRAL] Yes, it's 022-03919.
[AGENT][NEUTRAL] Got it. And what was the name and date of birth for the member, please?
[CUSTOMER][NEUTRAL] Uh, [PII] [PII].
[AGENT][POSITIVE] Perfect, thank you for verifying that, [PII] and what was the date of service for this claim?
[CUSTOMER][NEUTRAL] It's 39 $2025 for $150.
[AGENT][NEUTRAL] I'm sorry, what was that bill amount again, [PII]?
[CUSTOMER][NEUTRAL] 150.
[AGENT][NEUTRAL] 150. OK, got it. Thank you. One moment please.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, so we did receive this claim, [PII]. It looks like we're missing a copy of the primary EOB.
[CUSTOMER][NEUTRAL] Oh, that was sent, um, on [PII].
[AGENT][NEUTRAL] OK, I'm not showing that that has been received. Uh, the primary EOB does have to include amounts that were, um.
[AGENT][NEUTRAL] Paid towards co-pay, deductible and co-insurance.
[CUSTOMER][NEUTRAL] OK, um, so there was no payment from the primary insurance.
[AGENT][NEGATIVE] Not that we have received.
[CUSTOMER][NEUTRAL] OK, um, and where should I send it to?
[AGENT][NEUTRAL] Um, I've got a fax number and a mailing address.
[CUSTOMER][NEUTRAL] Uh, yeah, let me have the fax number.
[AGENT][NEUTRAL] Sure, that is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, and I, and of course send the claim with uh.
[CUSTOMER][NEUTRAL] Wow, because Cigna.
[CUSTOMER][NEGATIVE] Cigna denied it for your EOB and you're denying it for Cigna's EOB.
[AGENT][NEUTRAL] That's funny. So, um, this is a secondary medical policy, so it does require that major medical pays first.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Right, right, right, OK.
[CUSTOMER][POSITIVE] OK, I will give Signal a call thank you.
[AGENT][NEUTRAL] Of course. Was there anything else I can help you with?
[CUSTOMER][POSITIVE] Uh, no, that's it, thanks for your help.
[AGENT][POSITIVE] Alright, yeah, thanks for calling APL. I hope you have a great rest of your day.
[CUSTOMER][POSITIVE] You too thank you bye bye.
[AGENT][POSITIVE] Thank you. Bye-bye.