AccountId: 011433970860
ContactId: 4825e34a-45cb-407b-9431-15cf273299ad
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 235490 ms
Total Talk Time (AGENT): 70211 ms
Total Talk Time (CUSTOMER): 72789 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=1.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/10/4825e34a-45cb-407b-9431-15cf273299ad_20250410T12:40_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yeah, hi, [PII]. This is [PII] calling from provider service. And could you help me with the claim status?
[AGENT][POSITIVE] Yes, I'll be more than happy to help you with the claim that has been. May I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure. The callback number is [PII].
[CUSTOMER][NEUTRAL] [PII]. That's the direct line.
[AGENT][NEUTRAL] Thank you for that. And how many claims do you have in total today?
[CUSTOMER][NEUTRAL] I do have only one claim.
[AGENT][NEUTRAL] Alright, may I have the member's policy number?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yes, the member's ID is 02519728.
[AGENT][NEUTRAL] OK, can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] The member's first name is [PII] and the last name is [PII]. Date of birth is [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 date of service and the total bill for the claim you like me to check?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes, sure.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Date of service is [PII].
[CUSTOMER][NEUTRAL] And the bill amount is $6,744.79.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And what is the name of the provider's office on the claim?
[CUSTOMER][NEUTRAL] Yeah. It's Hendersonville Medical Center.
[AGENT][NEUTRAL] Alright, so I'm sure we received the claim on [PII].
[AGENT][NEUTRAL] The claim number is 3566593.
[AGENT][NEUTRAL] And on [PII], the claim was denied, requesting an explanation of benefits from primary insurance.
[CUSTOMER][POSITIVE] OK. Thank you so much for that information. Just hold on for a minute.
[CUSTOMER][NEUTRAL] Yes, ma'am. And make it, is there any
[CUSTOMER][NEUTRAL] Fax number to send the EOB?
[AGENT][NEUTRAL] Yes, our fax number is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] 942 [PII].
[CUSTOMER][POSITIVE] Thank you so much for that. May I know the attention?
[AGENT][NEUTRAL] That's attention, APL claims department.
[CUSTOMER][POSITIVE] Yeah. Thanks so much for that. And
[CUSTOMER][NEUTRAL] Nothing else needed out of this call. And may I get the call reference number?
[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] Thank you so much, [PII], and
[CUSTOMER][POSITIVE] Thank you so much for your assistance and have a great day.
[AGENT][POSITIVE] You're very welcome.
[AGENT][NEUTRAL] Alright, was there anything else I could assist you with today?
[CUSTOMER][POSITIVE] No, ma'am. Nothing else needed. Thank you so much.
[AGENT][POSITIVE] Alright, thanks for calling APL. Have a great day.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] You too.