AccountId: 011433970860
ContactId: 3ddd0018-f547-42cf-9d34-92f745f786fc
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 289200 ms
Total Talk Time (AGENT): 115370 ms
Total Talk Time (CUSTOMER): 89488 ms
Interruptions: 0
Overall Sentiment: AGENT=1.2, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/11/3ddd0018-f547-42cf-9d34-92f745f786fc_20250311T20:16_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, yes, this is [PII] with Christopher Rural Health, and I have a question on a, um, claim denial that was received.
[AGENT][NEUTRAL] OK, I can definitely help you with your claim [PII], and [PII], may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you for that. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] It is 02448372.
[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] Um, [PII], [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 um either the claim number if you have it or the date of service?
[CUSTOMER][NEUTRAL] Um, OK, let's see.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Claim number is 3571705.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] I'm just waiting for it to come up here. Hold on one moment.
[CUSTOMER][NEUTRAL] But.
[AGENT][NEUTRAL] OK, for some reason it's not coming up for me. This is what I have to do. Um, it has a
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEGATIVE] I have to reach out to claims to have a representative give you a call back. It's not coming up for us. Did you receive a letter?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEGATIVE] Yeah, it keeps denying stating that the the um provider tax ID number um.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Is there's an issue with that and um we have to send in a copy of the the W-2.
[CUSTOMER][NEGATIVE] And so I'm just trying to figure out what tax ID you're getting and why we keep getting the same denials every time we get these um from your insurance company.
[AGENT][NEUTRAL] OK, so what I'll do is reach out to [PII]. She's the one who handles um these claims that that's probably why I can't access it. She's the one who handles those claims, and she'll be able to give you a call back within 24 hours. It, it could be today, I just don't want to, I don't know what time she leaves and I don't want to say today if we can't, um.
[AGENT][POSITIVE] But she will give you a call back to go over all of this with you and to let you know next steps or what we need and what she's looking for.
[CUSTOMER][NEUTRAL] OK, and what did you say your name was?
[AGENT][NEUTRAL] My name is [PII].
[CUSTOMER][NEUTRAL] OK, and is there a reference number for this call?
[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] OK, sounds good thank you for your help. What's that?
[AGENT][NEUTRAL] And just
[AGENT][NEUTRAL] You're welcome. So phone number [PII] is the best contact number?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And what is the name of the provider's office?
[CUSTOMER][NEUTRAL] Christopher Rural Health Planning Corporation.
[AGENT][NEUTRAL] OK, so I'm sending this over to her now and I'll mark it urgent so that if she is still here, she can give you a call today. If not, it'll be tomorrow.
[CUSTOMER][NEUTRAL] OK, and let her know it's our [PII] location because we have 15 clinics so.
[CUSTOMER][NEUTRAL] She may be looking for.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] Can you spell the name of the city? I know I spelled that wrong.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, decline.
[CUSTOMER][NEUTRAL] The [PII] and the Q are both capitalized.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Alright, so I'll go ahead and send this over for you now. And [PII], was there anything else I can help you with today?
[CUSTOMER][POSITIVE] Nope that's it thank you.
[AGENT][POSITIVE] You're welcome and thanks for calling APL. I hope you have a great day.
[CUSTOMER][POSITIVE] Thanks you too.
[AGENT][POSITIVE] Thank you. Bye bye.
[CUSTOMER][NEUTRAL] Bye.