AccountId: 011433970860
ContactId: 383ed940-8722-4e4d-b9fc-39261997f8e2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 316000 ms
Total Talk Time (AGENT): 91031 ms
Total Talk Time (CUSTOMER): 61335 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/19/383ed940-8722-4e4d-b9fc-39261997f8e2_20250619T14:31_UTC.wav
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[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hello, this is [PII] calling from my doctor's office, checking on a denied claim.
[AGENT][NEUTRAL] Sure, [PII], I can assist you with claim status. Um first, could I get a good callback number just in case we're disconnected?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Thank you. Now I need the policy number, please.
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] It is one moment.
[CUSTOMER][NEUTRAL] 025457774
[AGENT][NEUTRAL] And please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Yes. Patient name is [PII], [PII].
[AGENT][NEUTRAL] And now I need the date of service and bill charges on the claim, please.
[CUSTOMER][NEUTRAL] Yes, it's one.
[CUSTOMER][NEUTRAL] 22,025 for the bill amount, $2,579 even.
[AGENT][NEUTRAL] OK, one moment, please.
[CUSTOMER][NEUTRAL] All right.
[AGENT][NEUTRAL] And what was the date of service, please repeat it.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK. Yes, sir. We received that claim on [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The claim processed um.
[AGENT][NEUTRAL] The claim processed on [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And the claim number is.
[AGENT][NEUTRAL] Claim number is 357-8841.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And this claim is denying because um the benefits were paid to the insured. Um, the insured submitted a claim and we received their claim first and so the benefits were paid to the insured.
[CUSTOMER][NEUTRAL] So you can bill it to the member, right?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] How, how much you have paid?
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] Yeah, it's it
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, it was a total of $3000 because there were other uh services combined with it and there's not a breakdown to show exactly how much was uh paid for uh this claim, but um it was a total of $3000 and the charges for this claim was included. Yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Bear with me.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] So we can bill it to the member, right?
[AGENT][POSITIVE] Yes, you can.
[CUSTOMER][NEUTRAL] OK, the reference number for this call please.
[AGENT][NEUTRAL] For the reference number, you can use my name and today's date. My name is [PII]. Um it's spelled [PII] Last initial is [PII], and today's date. Um do you need the claim number?
[CUSTOMER][NEUTRAL] You have already gave it to me that is 357-884-1, correct?
[AGENT][POSITIVE] Yes, that's correct. OK. Just making sure.
[CUSTOMER][POSITIVE] OK, alright, thank you, thank you so much for all your information, E. You have a good day. Bye for now.
[AGENT][NEUTRAL] You do the same, [PII]. Thank you for calling IPL. bye.