AccountId: 011433970860
ContactId: 524841fb-572e-4e1d-acd8-89929cc675c1
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 348079 ms
Total Talk Time (AGENT): 80497 ms
Total Talk Time (CUSTOMER): 103216 ms
Interruptions: 1
Overall Sentiment: AGENT=0.8, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/11/524841fb-572e-4e1d-acd8-89929cc675c1_20250611T20:23_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], my name is [PII]. I'm calling from provider's office to check on a claims.
[AGENT][NEUTRAL] All right, [PII], happy to check a claim. What's the policy number?
[CUSTOMER][NEUTRAL] Uh, the policy ID number is going to be.
[CUSTOMER][NEUTRAL] 024933
[CUSTOMER][NEUTRAL] 93 M. Mary L. Lima 7.
[AGENT][POSITIVE] Thank you. And do you have a good callback number?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. What is the patient name and date of birth?
[CUSTOMER][NEUTRAL] It's for [PII], [PII].
[AGENT][POSITIVE] Thank you and then data service.
[CUSTOMER][NEUTRAL] It is $220 of $2025 for $324 even.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] OK, so it looks like we did receive this claim on [PII]. Claim was denied on [PII]. Uh, the claim was denied, office visits are not covered under the member's policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And uh the last time we had requested uh the fax, the copy of it in your V and we haven't received it yet. Is it possible for you to uh resend that?
[AGENT][NEUTRAL] Mhm. What's the fax number?
[CUSTOMER][NEUTRAL] OK, the fax number, yeah, for the same patient, I have to 3 games. Uh, is it possible for you to send it all three along? It's for 221 and 224, the other two data services.
[AGENT][NEUTRAL] I'll have to send one at a time. So if you'll go ahead and give me the fax number, I can check the other ones and then send those.
[CUSTOMER][NEUTRAL] Sure. It's [PII], and attention to [PII].
[AGENT][NEUTRAL] Attention to who again?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Just to confirm the number again was [PII]?
[CUSTOMER][POSITIVE] Perfect.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] They put on.
[CUSTOMER][NEUTRAL] Refresh my refresh.
[CUSTOMER][NEUTRAL] You.
[AGENT][NEUTRAL] What's the next date of service?
[CUSTOMER][NEUTRAL] [PII] for $599.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, so it looks like this claim was also received denied for the same reason for office visits not being covered under member policy.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] other things.
[AGENT][NEUTRAL] Both those EUBs are on their way. What's the last data service?
[CUSTOMER][NEUTRAL] The largest service is 224 of 2025.
[AGENT][NEUTRAL] 599.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] not
[AGENT][NEUTRAL] Alright, last DOB is on its way. Were there any others you needed me to check today?
[CUSTOMER][NEUTRAL] Uh, no, that's it.
[CUSTOMER][NEUTRAL] And may I get the call reference number?
[AGENT][POSITIVE] Alright, thank you for calling AP.
[AGENT][NEUTRAL] Call reference is my name on today's date. My name is [PII], that's [PII] Last initial [PII] and then uh today's date.
[CUSTOMER][POSITIVE] OK, thanks a lot and thank you for providing the information. You have a wonderful day and bye for now.
[AGENT][NEUTRAL] You too bye bye.