AccountId: 011433970860
ContactId: 48afa720-e28c-484c-962f-cd50acf025b1
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 173759 ms
Total Talk Time (AGENT): 78972 ms
Total Talk Time (CUSTOMER): 50658 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/21/48afa720-e28c-484c-962f-cd50acf025b1_20250521T18:26_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII] I'm a provider looking for the status of a claim.
[AGENT][NEUTRAL] Alrighty, I could check on that claim for you. [PII], can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII] no extension.
[AGENT][NEUTRAL] OK, thank you. And then do you have the policy number?
[CUSTOMER][NEUTRAL] Yes, 02458538.
[AGENT][NEUTRAL] OK, and then what was the name and date of birth for the member please?
[CUSTOMER][NEUTRAL] That would be [PII].
[CUSTOMER][NEUTRAL] Date of birth [PII].
[AGENT][NEUTRAL] Alright, thank you for verifying that and then what was the date of service for this claim, please?
[CUSTOMER][NEUTRAL] That would be [PII].
[CUSTOMER][NEUTRAL] This will be for 300 even.
[AGENT][NEUTRAL] 300. OK, thank you one moment.
[CUSTOMER][POSITIVE] No problem.
[AGENT][NEUTRAL] OK. Was this with uh Center for uh diagnostic, um, I was just a diagnostic imaging, yeah.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, alrighty, so we did receive this claim, uh, we were unable to pay that benefit as their outpatient benefit for the calendar year has been met.
[AGENT][NEUTRAL] Or had as of [PII].
[CUSTOMER][NEUTRAL] I'm sorry, could you repeat that one more time?
[AGENT][NEUTRAL] Sure, the outpatient benefit for the calendar year had been met, so we were unable to pay a benefit.
[AGENT][NEUTRAL] If you'd like I can send you a copy of this EOB.
[CUSTOMER][NEUTRAL] Uh, no, it's OK. Um, could I have the, yes, and the, and the denial date please.
[AGENT][NEUTRAL] OK, did you need the claim number?
[AGENT][NEUTRAL] Sure, uh, so that claim number is 35.
[AGENT][NEUTRAL] 81353
[AGENT][NEUTRAL] And it looks like this claim processed on [PII].
[CUSTOMER][POSITIVE] Perfect. And then can I also have a reference number?
[AGENT][NEUTRAL] Sure, that would just be my first name, last initial [PII]'s date, uh so my name is spelled [PII]
[AGENT][NEUTRAL] Oh, is there anything else I could help you with, [PII]?
[CUSTOMER][NEUTRAL] Uh, no, ma'am, that's the only claim I needed to check on today.
[AGENT][POSITIVE] Alright, well thanks for giving us a call. I hope you have a great rest of your day.
[CUSTOMER][NEUTRAL] You as well bye bye.
[AGENT][POSITIVE] Thank you bye bye.