AccountId: 011433970860
ContactId: 51cb432e-de62-4998-a951-ae93a883970d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 333480 ms
Total Talk Time (AGENT): 83240 ms
Total Talk Time (CUSTOMER): 139779 ms
Interruptions: 1
Overall Sentiment: AGENT=0.4, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/16/51cb432e-de62-4998-a951-ae93a883970d_20250416T17:36_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. This is [PII] here calling from the provider office to check on the claim status.
[AGENT][POSITIVE] All right, I'm happy to check on a claim for you today, [PII]. Can I get the policy number?
[AGENT][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Yes, I'm there.
[AGENT][NEUTRAL] Can I get the policy number when you're ready, please?
[CUSTOMER][NEUTRAL] 02564245
[CUSTOMER][NEUTRAL] 844.
[AGENT][NEUTRAL] And do you have a good call back number?
[CUSTOMER][NEUTRAL] [PII] mhm OK.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Date of birth?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Data service.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] One
[CUSTOMER][NEUTRAL] 3000608.
[CUSTOMER][NEUTRAL] Charlie 6.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] 30006.
[CUSTOMER][NEUTRAL] Boy Charlie.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] I'm still here.
[CUSTOMER][NEUTRAL] Can you help me with this claim?
[AGENT][NEUTRAL] I'm still waiting on the data service, ma'am.
[CUSTOMER][NEUTRAL] [PII]. The total charge $83,978. 65 cents.
[CUSTOMER][NEUTRAL] Please spell that.
[AGENT][POSITIVE] All right thank you one moment.
[CUSTOMER][NEUTRAL] There
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] the
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] Right, so we received this claim on [PII].
[AGENT][NEUTRAL] Claim was denied [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The insured's primary insurance provided full benefits. There was nothing for us to pay.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] So primary insurance has paid more than allowable, right?
[AGENT][NEGATIVE] They've paid the claim in its entirety. There was nothing for us to pay.
[CUSTOMER][NEUTRAL] Yes, that only. So the primary has paid more.
[AGENT][NEUTRAL] The primary covered the expense, yes.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][MIXED] OK, but I can see here that uh the denial codes missing, uh.
[CUSTOMER][NEUTRAL] We have missing the denial code is in secondary UB. Can you help me with that denal?
[AGENT][NEUTRAL] I can send you the EOB via fax. Do you have a fax number?
[CUSTOMER][NEUTRAL] Uh, just a moment.
[CUSTOMER][NEUTRAL] Uh, the, uh, fax number will be [PII]. Attention to patient account number [PII].
[AGENT][NEUTRAL] OK, so just to confirm the fax number, it was [PII]. Is that correct?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Can you please provide me the claim number?
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] 354-043-8
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] Is there anything else I can check on for you today?
[CUSTOMER][POSITIVE] Yes, just give me some time.
[AGENT][NEUTRAL] I'm sorry, what was that again?
[CUSTOMER][NEUTRAL] OK, can I have the call reference number for this claim?
[AGENT][NEUTRAL] Call reference is my name with my last initial, then today's date. My name again is [PII], that's [PII]
[AGENT][NEUTRAL] My last initial is [PII].
[AGENT][NEUTRAL] And then today's date.
[CUSTOMER][POSITIVE] OK. Thank you for assisting me out. Have a great day. Bye-bye.
[AGENT][NEUTRAL] You too bye bye.