AccountId: 011433970860
ContactId: 48477efc-0e5a-440a-81d6-0415631f8acd
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 951190 ms
Total Talk Time (AGENT): 157507 ms
Total Talk Time (CUSTOMER): 278393 ms
Interruptions: 1
Overall Sentiment: AGENT=0.1, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/15/48477efc-0e5a-440a-81d6-0415631f8acd_20250415T16:27_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey, [PII], it's [PII] calling from the provider office to know the claim status.
[AGENT][NEUTRAL] Hey [PII], I can help you with claim status. Do you have a good callback number?
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] My number is [PII].
[AGENT][NEUTRAL] OK. And do you have the policy number of the patient?
[CUSTOMER][NEUTRAL] Yeah, just wait a second.
[CUSTOMER][NEUTRAL] The policy number is 01887176.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] And patient name and date of birth?
[CUSTOMER][NEUTRAL] The name is [PII].
[AGENT][NEUTRAL] The date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you and you have the uh date of service?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the build them out?
[CUSTOMER][NEUTRAL] $31,856 even.
[CUSTOMER][NEUTRAL] like you
[AGENT][NEUTRAL] It looks like we received 113-2025, processed 115 2025.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] It looks like we need a copy of the explanation of benefits.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] And.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] As for checking, we have already sent you the explanation of benefits previously multiple times.
[AGENT][NEUTRAL] When was it, sir?
[CUSTOMER][NEUTRAL] Via fax. Can you just cross check the fax number?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] You didn't receive it, right?
[AGENT][NEUTRAL] Correct, I don't show it on file.
[CUSTOMER][NEUTRAL] OK. Is there any attention to your fax number?
[AGENT][NEUTRAL] That goes straight to our claims department.
[CUSTOMER][NEUTRAL] OK. Please send you once again.
[AGENT][NEUTRAL] I'm Sorry?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Can I have a call reference number?
[AGENT][NEUTRAL] A call reference number is my name, [PII], first initial to last name [PII], and today's date.
[CUSTOMER][NEUTRAL] OK. I have a more cream. Can you just help me with it?
[AGENT][NEUTRAL] Uh, say another claim?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Right, that is the same person or a different policy?
[CUSTOMER][NEUTRAL] Different person.
[AGENT][NEUTRAL] OK, and the policy number?
[CUSTOMER][NEUTRAL] Yeah, just wait a second.
[CUSTOMER][NEUTRAL] The policy number is 02141739.
[AGENT][NEUTRAL] Uh, patient name and date of birth?
[CUSTOMER][NEUTRAL] The patient name is [PII] and date of birth, [PII].
[AGENT][NEUTRAL] And the date of service?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] And the build out?
[CUSTOMER][NEUTRAL] It's $8,853 even.
[CUSTOMER][NEUTRAL] But
[AGENT][POSITIVE] OK, thank you. And let's see.
[CUSTOMER][NEUTRAL] Bye.
[CUSTOMER][NEUTRAL] No
[AGENT][NEUTRAL] It looks like we received that 3-12-2025 process same day.
[AGENT][NEUTRAL] Um, based on the explanation of benefits received.
[AGENT][NEUTRAL] Uh, only payable of major medical insurance provides benefits.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEGATIVE] So it looks like the EOB we showed no benefits were paid, so we're, we aren't paying it.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. But in this also we have already sent you.
[AGENT][NEGATIVE] Right, we received it, but it indicated that nothing was paid by major medical, so if they don't pay, we don't pay on the policy.
[CUSTOMER][NEUTRAL] May, OK.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, just wait a second.
[CUSTOMER][POSITIVE] OK, thank you so much for waiting.
[CUSTOMER][NEUTRAL] I'll provide you with another policy number.
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEUTRAL] Yeah, sure. The call reference number will be the same for all of them, right?
[AGENT][NEUTRAL] Yes, what's the next policy?
[CUSTOMER][NEUTRAL] Wait a second.
[CUSTOMER][NEUTRAL] It's 02138724.
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] Name [PII]. Date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And date of service, build them out.
[CUSTOMER][NEUTRAL] D of service, [PII]. Total charge amount $12,866 and
[CUSTOMER][NEUTRAL] 50 cents.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, looks like we received that [PII], process 8-222024.
[AGENT][NEUTRAL] And we needed an explanation of the benefits.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] In this also we have already sent you the primary UB. You didn't receive it yet, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] OK. We will send you once again.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] I got 2 more claims. I'll provide you the policy number.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It's rain
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] The policy number is 01866994.
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] Patient name [PII]. Date of birth [PII].
[AGENT][NEUTRAL] And date of service and build them out?
[CUSTOMER][NEUTRAL] Date of service [PII] and total charge amount $17,909 even.
[AGENT][NEUTRAL] Have you received that 99 2024, process 9-12 2024 and
[AGENT][NEUTRAL] In a copy of the explanation of benefits.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] In this also we have already sent you.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] I don't show it on file.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] We will send you via fax. Can we send to you via mail again cause via fax it.
[CUSTOMER][NEUTRAL] Not going, I think.
[AGENT][NEUTRAL] Uh, sure, mailing address is [PII].
[CUSTOMER][NEUTRAL] Can, can you just tell me the billing address?
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII], [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I'll provide your last policy number.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right
[AGENT][NEUTRAL] And what is it?
[CUSTOMER][NEUTRAL] The policy number is 02464281.
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] Patient name [PII]. Date of birth, [PII].
[AGENT][NEUTRAL] And date of service and build them out.
[CUSTOMER][NEUTRAL] Rate of service.
[CUSTOMER][NEUTRAL] [PII] and total charge amount $12,0007 even.
[AGENT][NEUTRAL] Um, it looks like this policy started [PII]. Let me look at the other policy.
[AGENT][NEUTRAL] You said [PII]?
[CUSTOMER][NEUTRAL] Yes, actually, it's a date range.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh, it's [PII].
[AGENT][NEUTRAL] Um, I don't have the claim on file.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK. Actually, we have received a correspondence stating the you need the explanation of benefits.
[AGENT][NEUTRAL] OK, um, I don't know, do they have a claim number?
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] The claim number is 3496044.
[CUSTOMER][NEUTRAL] Sorry, sorry, sorry. Just wait a second.
[CUSTOMER][NEUTRAL] It's 352-750-9.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, OK, yes, it looks like we need the explanation of benefits, yes.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] OK. We will send you.
[CUSTOMER][POSITIVE] OK, thank you so much, [PII].
[AGENT][POSITIVE] Thank you, thanks for calling APL. I hope you have a good day.
[CUSTOMER][NEUTRAL] You too. Bye-bye.
[AGENT][NEUTRAL] I