AccountId: 011433970860
ContactId: 45805153-caea-41f8-a6fe-2192b6637420
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 560260 ms
Total Talk Time (AGENT): 158322 ms
Total Talk Time (CUSTOMER): 134499 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/01/45805153-caea-41f8-a6fe-2192b6637420_20250401T19:10_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Hi, this is [PII] from provider's office to check on a claim status.
[AGENT][POSITIVE] OK, I'm happy to check on a claim status for you today too. Can I get the patient's policy number?
[CUSTOMER][NEUTRAL] Yeah, 02506184.
[AGENT][NEUTRAL] OK, one moment please.
[AGENT][NEUTRAL] And may I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII] and the date of birth [PII].
[AGENT][NEUTRAL] Alright, and date of service?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the build amount?
[CUSTOMER][NEUTRAL] $10,590 even.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] This claim was received on [PII].
[AGENT][NEUTRAL] The claim was denied on [PII]. We requested the primary EOB.
[CUSTOMER][NEUTRAL] Yeah, but we already submitted the primary OB on uh um [PII] through fax.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Alright, it looks like we did receive that. Uh, looks like.
[AGENT][NEUTRAL] On [PII], the claim was processed on [PII]. There was a benefit payment sent in the amount of $3,596.83 in a single check.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Check number?
[AGENT][NEUTRAL] 203.
[AGENT][NEUTRAL] 6288.
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I completed.
[CUSTOMER][NEUTRAL] Hey.
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Yeah, did you get the check number?
[CUSTOMER][NEUTRAL] Yeah, 203-6288, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Yeah, check uh date is uh [PII], right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Uh, OK. May I get to know the
[CUSTOMER][NEUTRAL] Check pay to address.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] Check was sent to Grand Stan Regional Medical Center at [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. Um, could you help me to check with another claim?
[AGENT][NEUTRAL] I'm sorry, check the what on the claim?
[CUSTOMER][NEUTRAL] Uh, another thing.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Same patient or different?
[CUSTOMER][NEUTRAL] Uh, different.
[AGENT][NEUTRAL] Uh, yeah, I can check that. Let me notate this and we can check the next 11 moment.
[CUSTOMER][NEUTRAL] Yeah, OK.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] What's the next member's policy?
[CUSTOMER][NEUTRAL] 01648436.
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] Name uh [PII] and the date of birth, [PII].
[AGENT][NEUTRAL] OK, thank you for that. And then what's the date of service?
[CUSTOMER][NEUTRAL] Uh, date of service, [PII].
[AGENT][NEUTRAL] In the bill amount.
[CUSTOMER][NEUTRAL] The amount $6,391 even.
[AGENT][POSITIVE] Thank you. One moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So we did receive this claim on [PII]. Claim was denied on [PII], requesting the primary EOB.
[CUSTOMER][NEUTRAL] OK. Uh, we submitted the primary U be on uh [PII].
[AGENT][NEGATIVE] Don't show anything on file.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] May I get your mailing address or fax number to submit the primary OB?
[AGENT][NEUTRAL] Fax number is 877365.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 942 3.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, timely filing limit?
[AGENT][NEGATIVE] No timely filing.
[CUSTOMER][NEUTRAL] OK. And the fax attention?
[AGENT][NEUTRAL] I'm sorry, what was that again, [PII]?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Facts attention.
[AGENT][NEUTRAL] To claims
[CUSTOMER][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Could you help me to check with another claim?
[AGENT][NEUTRAL] Yep, let me just notate this one and we can check the next one moment.
[CUSTOMER][NEUTRAL] Yeah, sure.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] What's the next member ID?
[CUSTOMER][NEUTRAL] 02450166
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Date of birth?
[CUSTOMER][NEUTRAL] What? OK. Date of birth, uh, [PII].
[AGENT][POSITIVE] Thank you and data service and build them out.
[CUSTOMER][NEUTRAL] 1021, 2024 build amount $50,680 even.
[AGENT][NEUTRAL] This claim was received [PII], denied on [PII], requesting a primary EOB.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] We submitted the primary will be on uh [PII].
[AGENT][NEUTRAL] I don't show anything else on file.
[CUSTOMER][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] May I get the call reference number?
[AGENT][NEUTRAL] Call references my name with my last initial than today's date. My name again is [PII]. Last initial is [PII].
[CUSTOMER][POSITIVE] OK. Thank you for your assistance. Have a great day.
[AGENT][NEUTRAL] You too bye bye.
[CUSTOMER][NEUTRAL] Yeah, bye.