AccountId: 011433970860
ContactId: 5ba45c8a-8264-4ad3-8417-7c645648c70d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 359109 ms
Total Talk Time (AGENT): 137626 ms
Total Talk Time (CUSTOMER): 73274 ms
Interruptions: 2
Overall Sentiment: AGENT=0.3, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/03/5ba45c8a-8264-4ad3-8417-7c645648c70d_20250303T16:19_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII] calling from provider's office to check the claim status.
[AGENT][NEUTRAL] OK, I can verify claim status for you and [PII], what is that policy number, please?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] 0167748 M.
[AGENT][NEUTRAL] Um, no, ma'am. It sounds like it's missing the number. Do you have a copy of the card in front of you?
[CUSTOMER][NEUTRAL] One moment.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Is that X as in X-[PII] [PII]?
[AGENT][NEUTRAL] No, ma'am. Are you looking at the card for APL?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, do you see an in-hospital or outpatient benefit certificate number at the bottom?
[CUSTOMER][NEUTRAL] I do have the claim number.
[AGENT][NEUTRAL] OK, what's the claim number?
[CUSTOMER][NEUTRAL] 352-016-2
[AGENT][NEUTRAL] OK, give me one moment. And [PII], do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] OK, and verify the patient's name, date of birth.
[CUSTOMER][NEUTRAL] Yes, patient's name is [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] OK, let's see it's.
[AGENT][NEUTRAL] Uh, show this claim looks like for data services 712 24 in amount of $10,825. Is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, I've shown the claim process is meeting the primary insurance explanation of benefits.
[CUSTOMER][NEUTRAL] One moment.
[CUSTOMER][NEGATIVE] One moment, please. It was denied.
[AGENT][NEUTRAL] The claim processed as needing the primary insurance explanation of benefits.
[CUSTOMER][NEUTRAL] OK, that was denied or paid?
[AGENT][NEUTRAL] It was not paid, the claim is pending the primary insurance explanation of benefits.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Yeah, we have already sent the primary UB. Did you receive that?
[AGENT][NEUTRAL] Oh, we have not received it, ma'am. No, ma'am, because they're asking for it with that claim number you gave.
[CUSTOMER][NEUTRAL] OK. When, when it was received.
[AGENT][NEUTRAL] Uh, the claim number you gave me one moment.
[AGENT][NEUTRAL] And this is for.
[AGENT][NEUTRAL] OK, I'm showing that claim initially received [PII].
[AGENT][NEGATIVE] Process on [PII], and I do not show that EOB has been received.
[CUSTOMER][NEUTRAL] OK, [PII], right?
[AGENT][NEUTRAL] It's when the claim was processed, correct.
[CUSTOMER][NEUTRAL] OK. Uh, what is the mailing address, please?
[AGENT][NEUTRAL] Uh, mail address [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Correct, [PII].
[CUSTOMER][NEUTRAL] What is the zip code?
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK. Can I get the fax number, please?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK. Can I get the timely filing limit?
[AGENT][NEUTRAL] Uh, there isn't one.
[CUSTOMER][NEUTRAL] I'm sorry? No timely filing, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Is the claim number is correct which I provided you?
[AGENT][NEUTRAL] Uh, yes, that's the claim number you gave.
[CUSTOMER][NEUTRAL] OK. One moment.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK, and is there anything else I can assist you with today, [PII]?
[CUSTOMER][NEUTRAL] Yes. So, can I get the call reference number, please?
[AGENT][NEUTRAL] Uh, we don't give call reference numbers. If you like, you may use my name at today's date.
[CUSTOMER][NEUTRAL] Can you spell out your name?
[AGENT][NEUTRAL] Sure. [PII] [PII].
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] OK. Thank you so much for providing the information. Have a nice day. Thank you.
[AGENT][POSITIVE] Oh, you're welcome, [PII]. Thanks for calling APL. Bye.