AccountId: 011433970860
ContactId: 5b8a6a85-3967-4155-8a66-b4cb6762c902
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 189110 ms
Total Talk Time (AGENT): 75532 ms
Total Talk Time (CUSTOMER): 61094 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/25/5b8a6a85-3967-4155-8a66-b4cb6762c902_20250425T13:18_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hello, good morning. My name is [PII]. I am calling from a provider's office regarding a claim, please.
[AGENT][NEUTRAL] I'm sure, [PII], I can assist you with claim status. Um, first, could I get a good callback number just in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. Now, I need the policy number, please.
[CUSTOMER][NEUTRAL] Yes, so the policy number is 01611726 M as in Mary, L as in Larry, and the number 7.
[AGENT][NEUTRAL] Thank you. Now, please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] OK, thank you. Now, I need the date of service and bill charges on the claim.
[CUSTOMER][NEUTRAL] Yes, [PII] 8 2024 $348.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. Yes, ma'am. Thanks for your patience. Um, I show that we received this claim on [PII] and it processed on [PII].
[AGENT][NEUTRAL] The claim number is 3547491 and I'm showing that this claim is denying because the um EOB, the primary carrier is EOB that was sent in with the claim, shows that the primary carrier did not cover the charge. And if the primary carrier does not cover a charge, then as the secondary insurance, we don't cover it either.
[CUSTOMER][NEUTRAL] OK. Now, could you repeat that claim number for me? Is it 3547491?
[AGENT][POSITIVE] Yes, ma'am, that's correct.
[CUSTOMER][NEUTRAL] OK. Just allow me one moment because
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] It.
[CUSTOMER][NEGATIVE] That they did not cover.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It's primary deny, you deny as well. It's a primary deny. OK. Thank you so much. Can I have a reference number, please?
[AGENT][NEUTRAL] Um, yes, ma'am. For the reference number, you can use my name and today's date. My name is [PII], um, it's spelled [PII] My last initial is [PII] and today's date. Is there anything else I can assist you with?
[CUSTOMER][POSITIVE] Oh, thank you.
[CUSTOMER][POSITIVE] No, none at this time. Thank you so much.
[AGENT][POSITIVE] You're welcome, [PII]. Thank you for calling APL. Have a great weekend. Bye.
[CUSTOMER][POSITIVE] It's too easy, thank you.