AccountId: 011433970860
ContactId: 43b90c3e-9f63-4daa-bdda-66e0f6f7a5f0
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 278040 ms
Total Talk Time (AGENT): 117914 ms
Total Talk Time (CUSTOMER): 57781 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/30/43b90c3e-9f63-4daa-bdda-66e0f6f7a5f0_20250130T15:14_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] and initial of my last name is [PII], and I've called you to know more on a claim.
[AGENT][NEUTRAL] OK, I'm sorry, what kind of information do you need?
[CUSTOMER][NEUTRAL] A claim status.
[AGENT][NEUTRAL] Claim status, OK. And could you spell your first name for me?
[CUSTOMER][NEUTRAL] Yes, it's [PII]
[AGENT][NEUTRAL] OK, well, thank you. And what is your callback number?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] OK, thank you. And do you only have one claim that you're needing to check status on?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Yes, I can help you. And what is your call I'm sorry, the policy number for the member?
[CUSTOMER][NEUTRAL] It is 01982175, M as in Mary, L as in Lima, number 8.
[AGENT][NEUTRAL] OK, thank you. Give me a moment, I will get the member's information pulled up please.
[CUSTOMER][NEUTRAL] OK, [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And any information on all that I do provide for you today will be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] It's [PII], [PII].
[AGENT][NEUTRAL] Spell the first name?
[CUSTOMER][NEUTRAL] It's
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII], is that correct?
[CUSTOMER][NEUTRAL] You too.
[CUSTOMER][POSITIVE] Yes, correct.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And the date of service and total bill amount for her, please.
[CUSTOMER][NEUTRAL] It's [PII] and $950 even.
[AGENT][NEUTRAL] 950.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, and also this claim was received on [PII].
[AGENT][NEUTRAL] It was processed on [PII]. The claim number is 3536644.
[AGENT][NEUTRAL] And this claim has been denied at this point and the reason for the denial states to please provide copies of the primary insurance company's explanation of benefits.
[CUSTOMER][NEUTRAL] All right. And we can fax that to you.
[AGENT][NEUTRAL] You can.
[CUSTOMER][NEUTRAL] OK. And what will the number for that?
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] The claims fax number will be [PII]. Attention claims.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And then I will also once the claim has been processed with APL we do have a portal that you can also check claim status and have access to the explanation of benefits for APL by going to secured. [PII].
[CUSTOMER][NEUTRAL] All right.
[AGENT][NEUTRAL] All right. And is there anything?
[CUSTOMER][POSITIVE] OK. Thank you for that info.
[AGENT][POSITIVE] You're very welcome. And can I help you with anything else today?
[CUSTOMER][NEUTRAL] Please help me with the call reference number for this.
[AGENT][NEUTRAL] You would use my name along with today's date.
[CUSTOMER][NEUTRAL] All right. Can you spell out your first name?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] All right, [PII]. Thank you so much. Have a great day.
[AGENT][POSITIVE] You. Yes, sir. I hope you have a nice day too, and thank you again for calling APL.
[CUSTOMER][NEUTRAL] Alright bye bye.
[AGENT][NEUTRAL] Bye-bye.