AccountId: 011433970860
ContactId: 55a1a16a-5086-40e5-880f-80319871c9c7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 514919 ms
Total Talk Time (AGENT): 111548 ms
Total Talk Time (CUSTOMER): 139059 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/20/55a1a16a-5086-40e5-880f-80319871c9c7_20250320T17:19_UTC.wav
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[AGENT][POSITIVE] Thank you for calling APL. How can I help you?
[CUSTOMER][NEUTRAL] Hi, hello, my name is [PII].
[CUSTOMER][NEUTRAL] Uh, actually I'm calling from a provider's office to look up a claim.
[AGENT][NEUTRAL] OK, [PII], I can help you with claim status. Um, do you have a good call back number?
[CUSTOMER][NEUTRAL] Yeah, I do have a callback number [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, do you have the policy number?
[CUSTOMER][NEUTRAL] Policy number.
[CUSTOMER][NEUTRAL] Um, the policy number is 02450115.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] You have a patient name and date of birth?
[CUSTOMER][NEUTRAL] Patient's name it is.
[CUSTOMER][NEUTRAL] [PII] Date of birth of [PII].
[CUSTOMER][NEUTRAL] They don't
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] And do you have the date of service?
[CUSTOMER][NEUTRAL] Date of service [PII].
[AGENT][NEUTRAL] And what were those bill charges?
[CUSTOMER][NEUTRAL] Um, $1,156 even.
[AGENT][NEUTRAL] OK.
[AGENT][NEGATIVE] Sorry my system's running a little slow.
[CUSTOMER][POSITIVE] Yeah, no problem, take your time.
[AGENT][NEUTRAL] Uh, process that claim, and we do need an exclamation of benefits from the prime insurance carrier.
[CUSTOMER][NEUTRAL] So you need an uh explanation of benefit from primary information, right?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] Do you have a claim number?
[AGENT][NEUTRAL] Yes, it's 34
[AGENT][NEUTRAL] 421291.
[CUSTOMER][NEUTRAL] Um, I'm sorry for that. Um, but it's you, your sound just broke up, so can you please repeat it again from the beginning.
[AGENT][NEUTRAL] No, it's 342-1291.
[CUSTOMER][NEUTRAL] Mhm mhm.
[CUSTOMER][NEUTRAL] 91.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Uh, OK, when was the claim received and processed?
[CUSTOMER][NEUTRAL] Can you please provide me the date?
[AGENT][NEUTRAL] It was
[AGENT][NEUTRAL] Yes, it was [PII] received.
[AGENT][NEUTRAL] Processed [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII], right?
[AGENT][NEUTRAL] [PII], yes.
[CUSTOMER][NEUTRAL] Yeah [PII].
[CUSTOMER][NEUTRAL] Pro [PII]. OK, needing the primary I mean that.
[CUSTOMER][POSITIVE] OK, got it. Thank you so much for that. Uh, can you please provide me who is the primary for this one?
[AGENT][NEUTRAL] Um
[AGENT][NEUTRAL] Let me see.
[AGENT][NEUTRAL] Uh, I'm trying to see, hold on just a second.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Uh, looks like it's [PII].
[CUSTOMER][NEUTRAL] OK, uh, do you have a member ID?
[AGENT][NEUTRAL] Uh, not for their primary, no.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I do see one here. I just wanna verify the number I need that.
[CUSTOMER][POSITIVE] OK, no problem.
[AGENT][NEUTRAL] Yeah, I just have the carrier um name.
[CUSTOMER][NEUTRAL] OK, so I do have one more claims for the same patient.
[CUSTOMER][NEUTRAL] And it will be with a different, uh, with a different date of service I guess.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, hold on one moment
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK, I'm ready. What is that date of service?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the bill charges?
[CUSTOMER][NEUTRAL] $1130 even?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let's see
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Did you say [PII]? I'm sorry.
[AGENT][NEUTRAL] The date of service again?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] Uh, looks like we, that one is also needing a primary explanation of benefits.
[CUSTOMER][NEUTRAL] So this is also that I needed the primary information.
[AGENT][NEUTRAL] Yes, um, we received that [PII] processed January.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. Can you please provide me the call reference number and the name of your uh the and the spelling of your name, please?
[AGENT][NEUTRAL] Yes, uh
[AGENT][NEUTRAL] So, my name is [PII] and the reference is gonna be my first name, last initial. It's [PII]
[AGENT][NEUTRAL] Last initial is [PII].
[AGENT][NEUTRAL] And then today's date.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And today's date.
[AGENT][NEUTRAL] Yes, [PII].
[CUSTOMER][POSITIVE] OK, got it. Thank you so much, [PII].
[AGENT][NEUTRAL] OK, [PII], is there anything else I can help you with?
[CUSTOMER][NEUTRAL] No, that's all.
[AGENT][POSITIVE] OK, thank you for calling APL. I hope you have a great day.
[CUSTOMER][NEUTRAL] OK, you too.
[AGENT][POSITIVE] Thanks. Bye.