AccountId: 011433970860
ContactId: 3bae750c-8ea3-4396-9ead-3178b65a7dce
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 237630 ms
Total Talk Time (AGENT): 96303 ms
Total Talk Time (CUSTOMER): 125507 ms
Interruptions: 7
Overall Sentiment: AGENT=0.9, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/07/3bae750c-8ea3-4396-9ead-3178b65a7dce_20250507T13:55_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, so, I just hang up the phone with [PII], but I forgot an important question. She, I forgot to ask for the claim number. Oh my God. She gave me all the info, you know, it was the night, why was the night, blah blah blah blah blah. And then I, and then I'm like.
[AGENT][NEUTRAL] Oh
[AGENT][POSITIVE] OK, it's OK. I can assist you.
[CUSTOMER][NEGATIVE] I had to go back. So sorry. Let me, oh my God, I feel horrible. I, I need, I need 3 coffees instead of 2, instead of, I need more coffee. Anyways. Oh, I feel horrible. And then they give us like a
[AGENT][NEUTRAL] So
[AGENT][NEUTRAL] Mm.
[AGENT][POSITIVE] It's like it's the middle of the week. It's OK, we're getting there.
[CUSTOMER][NEUTRAL] I know, I know, I'm like, what did I call for? You to say hi. Anyways, let me give you the Tell me what information I'll give you the information. You guys do have the claim on file or it was denied.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, go ahead with the.
[AGENT][NEUTRAL] OK, go ahead with your name and a callback number just in case we get disconnected.
[CUSTOMER][NEUTRAL] Yeah, the subscriber ID?
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Yeah, my name is [PII] and my phone number is [PII].
[AGENT][NEUTRAL] Yeah, may I have the policy number?
[CUSTOMER][NEUTRAL] It is 945137 [PII].
[AGENT][NEUTRAL] OK, what's his date of birth?
[CUSTOMER][NEUTRAL] His date of birth [PII].
[AGENT][NEUTRAL] OK, all right.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] And you're calling from which facility?
[CUSTOMER][NEUTRAL] Moses Cosic Services, Mosesone Health.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] All right. And what was the date of service?
[CUSTOMER][NEUTRAL] D of service, [PII] for the amount of, let me do, $175. And it was denied for, um, but the primary came from United Healthcare. It covered and paid leaving $50 went to you guys and denied for, he said that it was exceeded the maximum visit, so only 3 allowed per year. And then I don't know what the claim number, and what was the claim process.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] Oh, OK, so you need the process date and the claim number, OK, um, let me pull the process date. No, OK.
[CUSTOMER][NEUTRAL] Yeah, she will fax me that you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so the claim number and this is for um.
[AGENT][NEUTRAL] J 06.9 procedure code 99213.
[CUSTOMER][NEUTRAL] Yes, 99213.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Of this
[AGENT][NEUTRAL] Uh, that is claim number 3558344.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And it was processed on let's see, here we go, received on [PII], process on [PII].
[CUSTOMER][NEUTRAL] OK. And it is uh OK number 3558344, right?
[AGENT][POSITIVE] That is correct, yes. Mhm.
[CUSTOMER][POSITIVE] Thank you so much. She will fax me the, the UV.
[AGENT][NEUTRAL] Um, do you need me to fax you the AOB or she's gonna fax it to you?
[CUSTOMER][POSITIVE] Thank you. I'm, I'm sorry. I'm sorry.
[CUSTOMER][NEUTRAL] Yeah, no, she, she, she's doing it.
[AGENT][NEUTRAL] OK, OK. All right. Is there anything else I may help you today?
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Are you?
[CUSTOMER][POSITIVE] No, thank you so much. That will be great. Thank you. Sorry.
[AGENT][POSITIVE] You're welcome. All right. You have a good day. It's OK, no problem, Ms. [PII]. Have a good day. You're welcome. OK. You're welcome. Bye-bye.
[CUSTOMER][POSITIVE] Thank you. Yes, yes, wake up. Thank you. Bye.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 34.