AccountId: 011433970860
ContactId: 534a3cba-e18c-4b3b-bab3-2d54f459068e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 350739 ms
Total Talk Time (AGENT): 131331 ms
Total Talk Time (CUSTOMER): 57467 ms
Interruptions: 0
Overall Sentiment: AGENT=1.2, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/14/534a3cba-e18c-4b3b-bab3-2d54f459068e_20250414T17:06_UTC.wav
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[AGENT][NEUTRAL] Afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Good afternoon. My name is [PII]. I'm calling from office. I'm looking for claim status.
[AGENT][NEUTRAL] OK, did you say that you're needing claim status, is that correct?
[CUSTOMER][POSITIVE] Yes, that's correct.
[AGENT][NEUTRAL] Yes, I can help you with that. And [PII], what is the callback number?
[AGENT][NEUTRAL] [PII], what is your callback number?
[CUSTOMER][NEUTRAL] Yes, that's [PII].
[AGENT][NEUTRAL] I'm sorry, did you say [PII]? Is that correct?
[CUSTOMER][POSITIVE] Yes, that's correct.
[AGENT][POSITIVE] Thank you and how many
[AGENT][NEUTRAL] Any claims sector, do you have to check status on?
[CUSTOMER][NEUTRAL] Just one, only one.
[AGENT][NEUTRAL] Yes, sir. OK. What is that? I can help you and what is the policy number for the patient?
[CUSTOMER][NEUTRAL] Is that number would be 0250.
[CUSTOMER][NEUTRAL] 5763 M as in Mary, L as in Lima, and number 8.
[AGENT][NEUTRAL] OK, thank you. One moment, please.
[AGENT][NEUTRAL] And [PII], any any information that I do provide for you today will be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] Patient's name is [PII].
[CUSTOMER][NEUTRAL] And her date of birth is [PII].
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] And what is the date of service and total bill amount, please?
[CUSTOMER][NEUTRAL] It was service this is [PII].
[CUSTOMER][NEUTRAL] And total charge amount is
[CUSTOMER][NEUTRAL] $620.
[AGENT][NEUTRAL] 620, is that correct?
[CUSTOMER][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] OK, so [PII], this claim was received the [PII].
[CUSTOMER][NEUTRAL] Well
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEGATIVE] It was processed and denied on [PII].
[AGENT][NEUTRAL] The claim number is 358.
[AGENT][NEUTRAL] 3046.
[AGENT][NEUTRAL] And the reason for the denial states benefits are payable only if the major medical insurance provider provides benefits. If this claim is later paid by the major medical insurance, please send the explanation of benefits showing benefits were paid.
[CUSTOMER][NEUTRAL] Actually we have sense claim with the primary UV.
[AGENT][NEUTRAL] Again
[AGENT][NEUTRAL] Benefits are only payable if the major medical insurance provider provides benefits.
[AGENT][NEUTRAL] If the claim is later paid by the major medical and please send the explanation of benefits, showing benefits were paid.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Perfect, may I know the reference number for our call?
[AGENT][NEUTRAL] Uh my name that I gave you along with today's date. And if you need a copy of this explanation of benefits with those remarks, [PII], you can print that from our portal now that you have the claim number by going to secured.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]. [PII]. That's [PII]. OK.
[AGENT][POSITIVE] Yes, sir, that is correct.
[AGENT][POSITIVE] Yes sir, that's correct.
[AGENT][NEUTRAL] So is there anything else, [PII], that I can help you with at the moment?
[CUSTOMER][POSITIVE] All right, thank you.
[CUSTOMER][POSITIVE] That's it. Thank you so much.
[AGENT][POSITIVE] Well, you're welcome and thank you for calling APL. I hope you have a great day.
[CUSTOMER][NEUTRAL] You too. Goodbye.
[AGENT][POSITIVE] Thank you. Bye bye.
[CUSTOMER][NEUTRAL] Yeah.