AccountId: 011433970860
ContactId: 3f934748-1a4e-432c-a6a4-9ccfbfc60fd7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1097959 ms
Total Talk Time (AGENT): 178457 ms
Total Talk Time (CUSTOMER): 328982 ms
Interruptions: 0
Overall Sentiment: AGENT=0.1, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/16/3f934748-1a4e-432c-a6a4-9ccfbfc60fd7_20250616T17:44_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hello [PII], this is [PII] calling from provider's office to check up on a claim status. Also, this call is being recorded for quality and training purposes. Are you OK with that?
[AGENT][NEUTRAL] Yes, that's fine.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Hey, do you have a good callback number?
[CUSTOMER][NEUTRAL] Um, sure, it would be [PII].
[AGENT][NEUTRAL] OK, and what is the policy number for the patient?
[CUSTOMER][NEUTRAL] Uh, just give me a moment
[CUSTOMER][NEUTRAL] Um, yeah, the policy number would be 1420763.
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] Member's name is [PII], and the date of birth is [PII].
[AGENT][NEUTRAL] Data service and bill charges.
[CUSTOMER][NEUTRAL] The of service is [PII]. Total charge $500 even.
[AGENT][NEUTRAL] The claim was received on 6-9-2025, 616-2025.
[CUSTOMER][NEUTRAL] 6
[AGENT][NEUTRAL] Uh, we need a copy of the primary EOB.
[CUSTOMER][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Can you help me with the claim number?
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] Claim number 361-319-8.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] Yeah, thank you. I can submit the Prime GB to you. Uh, yeah, can we move to next member?
[AGENT][NEUTRAL] Give me one moment.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] And the next policy number?
[CUSTOMER][NEUTRAL] It's 148.
[CUSTOMER][NEUTRAL] 4297.
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] Member's name is [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] This policy terminated [PII]. Let me see if there's a more active policy on file.
[CUSTOMER][NEUTRAL] So there is no active policy for this number.
[AGENT][NEUTRAL] I'm checking.
[AGENT][NEUTRAL] What was the date of service?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] It's [PII]. Total charge 9616, 0 sorry, uh, total charge $100 even.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, you said [PII]?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] A claim was received on 6-225, 6625.
[CUSTOMER][NEUTRAL] And
[AGENT][NEUTRAL] Uh, policy does not provide benefits for treatment of conditions other than sickness or injury.
[CUSTOMER][NEUTRAL] Is it uh denied as non-covered?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Under the member's plan, right?
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK sure thank you.
[CUSTOMER][NEUTRAL] Um, can you help me with the member's plan name?
[AGENT][NEUTRAL] My name is [PII].
[CUSTOMER][NEUTRAL] [PII]. OK, thank you. Can you help me with the claim number?
[AGENT][NEUTRAL] The number is 361-027-8.
[CUSTOMER][NEUTRAL] 361
[CUSTOMER][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Yeah, can we move to next member?
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] Patient name and date of birth? I'm sorry, the policy number?
[CUSTOMER][NEUTRAL] Yeah, it's 02.
[CUSTOMER][NEUTRAL] 556,090
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] Member's name is [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] And date of service and bill charges?
[CUSTOMER][NEUTRAL] It's [PII] total charge $104.50 104.50.
[AGENT][NEUTRAL] It was received 6225 process 6625.
[CUSTOMER][NEUTRAL] Uh, when did you receive that?
[AGENT][NEUTRAL] 6225.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I 6625?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Policy provides no benefits for treatment of conditions other than sickness or injury.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Just a moment. Can you also help me with the member's plan name?
[AGENT][NEUTRAL] A link
[CUSTOMER][NEUTRAL] Main.
[CUSTOMER][NEUTRAL] Just a moment.
[CUSTOMER][NEUTRAL] Just give me a moment.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Can you help me with the claim number?
[AGENT][NEUTRAL] 361.
[AGENT][NEUTRAL] 0370.
[CUSTOMER][NEUTRAL] 361.
[CUSTOMER][NEUTRAL] 0370.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Can we move to next number?
[AGENT][NEUTRAL] Policy number?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] It would be 024.
[CUSTOMER][NEUTRAL] 64799.
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] It's [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] Uh, um, native service.
[CUSTOMER][NEUTRAL] [PII], total charge $100 even.
[AGENT][NEUTRAL] Uh, this policy termed in 24. Let me see if there's a different one.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] The claim has received 662025 processed on the same day.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, policy provides no coverage other than injury or sickness.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Just give me a moment. Can you help me with the member's plan name?
[AGENT][NEUTRAL] A link
[CUSTOMER][NEUTRAL] Meddling.
[CUSTOMER][NEUTRAL] Thank you. Can you help me with the claim number?
[AGENT][NEUTRAL] 361-038-9.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Can we move to next member?
[AGENT][NEUTRAL] How many more claims do you have?
[CUSTOMER][NEUTRAL] Uh, actually, I do have 5 more claims.
[AGENT][NEUTRAL] Uh, policy number of the patient.
[CUSTOMER][NEUTRAL] It's 017.
[CUSTOMER][NEUTRAL] 0461 2.
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][NEUTRAL] of service and bill charges.
[CUSTOMER][NEGATIVE] Date of service [PII] total charge $500 even.
[AGENT][NEUTRAL] Receive 6225, 6625.
[AGENT][NEUTRAL] A copy of the primary EOB.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Thank you. Can you help me with the claim number?
[AGENT][NEUTRAL] I'm number 361-025-3.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Can we move to next number?
[AGENT][NEUTRAL] No no no.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] Policy number?
[CUSTOMER][NEUTRAL] Yeah, the next policy number would be 019.
[CUSTOMER][NEUTRAL] 12264.
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] Member's name is [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] In the service bill charges?
[CUSTOMER][NEUTRAL] Date of service [PII]. Total charge $500 even.
[AGENT][NEUTRAL] Process uh receive 62, process 66.
[AGENT][NEUTRAL] A copy of the primary EOB?
[CUSTOMER][NEUTRAL] OK, thank you. Can you help me with the claim number?
[AGENT][NEUTRAL] 610555
[CUSTOMER][NEUTRAL] Thank you, can we move to next number?
[AGENT][NEUTRAL] My policy number?
[CUSTOMER][NEUTRAL] What?
[CUSTOMER][NEUTRAL] Uh, uh, yeah, the next, your next policy ID number would be 02464411.
[AGENT][NEUTRAL] Policy
[AGENT][NEUTRAL] name and date of birth?
[CUSTOMER][NEUTRAL] Name [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] Data service bill charges?
[CUSTOMER][NEUTRAL] Date of service [PII] total charge $3500 even.
[AGENT][NEUTRAL] And receive 62, process 66, a copy of the primary AB.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Sure, I can submit the primary to you. Can you help me with the claim number?
[AGENT][NEUTRAL] 361-039-9.
[CUSTOMER][NEUTRAL] Thank you. Can we move to next number?
[AGENT][NEUTRAL] Policy number?
[CUSTOMER][NEUTRAL] Next policy number would be 017.
[CUSTOMER][NEUTRAL] 49477
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] Member's name is [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] Data service bill charges?
[CUSTOMER][NEUTRAL] Date of service is [PII]. Total charge $500 even.
[AGENT][NEUTRAL] I don't show that claim on file.
[CUSTOMER][NEUTRAL] Just a moment.
[CUSTOMER][NEUTRAL] Uh, the claim is not on file.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Can you help me with the mailing address and the patient's effective date and term date of the plan?
[AGENT][NEUTRAL] effective dates [PII] policies is active, no term date.
[AGENT][NEUTRAL] And mailing address is [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] OK sure thank you.
[CUSTOMER][NEUTRAL] Can we move to the next number, last one?
[AGENT][NEUTRAL] Policy number?
[CUSTOMER][NEUTRAL] It's 026-08026.
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] Member's name is [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] Data service and bill charges.
[CUSTOMER][NEUTRAL] It's [PII]. We'll charge $905 even.
[AGENT][NEUTRAL] I don't have any claim on file.
[CUSTOMER][NEUTRAL] Can you help me with the numbers effective and term date?
[AGENT][NEUTRAL] [PII] policy is active.
[CUSTOMER][NEUTRAL] [PII] OK.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Can you help me with the call reference number?
[AGENT][NEUTRAL] My name is [PII], first initial to last name [PII], and the day's date.
[CUSTOMER][POSITIVE] OK. Thank you so much, [PII], for your help. Hope you have a wonderful day.
[AGENT][POSITIVE] Thank you for calling APL you as well. Bye bye.