AccountId: 011433970860
ContactId: 467817ad-f861-4eb3-b428-cb5d7f99ed41
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 285470 ms
Total Talk Time (AGENT): 64831 ms
Total Talk Time (CUSTOMER): 111886 ms
Interruptions: 1
Overall Sentiment: AGENT=0.9, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/20/467817ad-f861-4eb3-b428-cb5d7f99ed41_20250520T12:59_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII] calling from provider's office to check on the claim status. How are you doing today?
[AGENT][POSITIVE] I'm good, thank you. I'm happy to check on a claim. What's the policy number?
[CUSTOMER][NEUTRAL] The policy number is 0240.
[CUSTOMER][NEUTRAL] 6206, M as in Mike, L as in Lima, and number 8.
[AGENT][NEUTRAL] May I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Patient's name is [PII].
[CUSTOMER][NEUTRAL] And his date of birth is [PII].
[AGENT][NEUTRAL] Thank you. And then what's the date of service?
[CUSTOMER][NEUTRAL] Ser
[CUSTOMER][NEUTRAL] The date of service is [PII] and for the bill amount of $315 even.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] Alright, so it looks like we did get a claim for the state of service. The claim was received on [PII].
[CUSTOMER][NEUTRAL] The claim was received on [PII].
[AGENT][NEUTRAL] The claim was denied on [PII].
[CUSTOMER][NEUTRAL] April.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] durable medical equipment is not covered under the member's policy.
[CUSTOMER][NEUTRAL] OK, DME is not covered on the member's policy?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] DME.
[CUSTOMER][NEGATIVE] Not cover.
[CUSTOMER][NEUTRAL] And uh how much is the patient responsible for?
[AGENT][NEUTRAL] We're not able to advise on patient responsibility that's up to the provider facility.
[CUSTOMER][NEUTRAL] Sure
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] Uh, can I get a copy of EOB?
[AGENT][NEUTRAL] Oh yeah, what's a good fax number?
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Should we mark attention?
[CUSTOMER][NEUTRAL] Then attention would be, yes, that would be my name [PII] and my last initial is [PII].
[AGENT][POSITIVE] All right. [PII], give me about 5 minutes and you should have that. Is there anything else we can help with today?
[CUSTOMER][NEUTRAL] That and you should
[CUSTOMER][NEUTRAL] Uh, what's the claim number for this?
[AGENT][NEUTRAL] 359-042-2
[CUSTOMER][NEUTRAL] 3
[CUSTOMER][NEUTRAL] 0422.
[CUSTOMER][NEUTRAL] 359-042-2 is the claim number.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] And what's your good name?
[AGENT][NEUTRAL] My name is [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Is it spelled as [PII]?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] OK, [PII].
[CUSTOMER][NEUTRAL] And uh give me one moment.
[CUSTOMER][NEUTRAL] And when will I receive the UB?
[AGENT][NEUTRAL] I should be there in the next 5 minutes.
[CUSTOMER][NEUTRAL] It should be
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And uh what's the call reference number for this call?
[AGENT][NEUTRAL] Call reference is my name.
[CUSTOMER][NEUTRAL] You don't have any provider?
[AGENT][NEUTRAL] For today's date.
[CUSTOMER][POSITIVE] Sorry to interrupt you, OK.
[CUSTOMER][NEUTRAL] And you don't have any provider discount in the patient responsibilities?
[AGENT][NEUTRAL] No, we don't advise on that.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK then thank you so much for the information you provided. Hope you have a great day. Take care for now bye bye.
[AGENT][NEUTRAL] You too. Bye-bye.