AccountId: 011433970860
ContactId: 5f67646a-f651-429a-9952-ebc0b8eed786
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 772130 ms
Total Talk Time (AGENT): 188817 ms
Total Talk Time (CUSTOMER): 207890 ms
Interruptions: 1
Overall Sentiment: AGENT=0.8, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/16/5f67646a-f651-429a-9952-ebc0b8eed786_20250416T14:42_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ETM. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yeah, hi, this is [PII] calling from Platinum Ting office. How are you doing today?
[AGENT][POSITIVE] I'm good. How are you, [PII]?
[CUSTOMER][POSITIVE] I'm doing great, thank you for asking. Before I proceed, this call is being recorded for quality and training purposes. Would you like us to continue the recording?
[AGENT][NEUTRAL] Yes, ma'am. That's fine.
[CUSTOMER][NEUTRAL] May I know your name?
[AGENT][NEUTRAL] My name is [PII]. It's spelled [PII] My last initial is [PII].
[CUSTOMER][NEUTRAL] OK, I have called regarding a claim information.
[AGENT][NEUTRAL] Um, yes, ma'am. I can assist you with claim status. Um, could I please get your name one more time and a good callback number just in case we're disconnected?
[CUSTOMER][NEUTRAL] Yeah, my name is [PII] and last name initial is [PII] and my callback number is [PII].
[AGENT][NEUTRAL] OK, thank you. And now I need the policy number, please.
[CUSTOMER][NEUTRAL] Yeah, it's 02039877 ML 8.
[AGENT][NEUTRAL] OK, one moment, please.
[AGENT][NEUTRAL] OK. Please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Patient name [PII].
[CUSTOMER][NEUTRAL] [PII] and the date of birth, [PII].
[AGENT][NEUTRAL] And the date of service and bill charges on the claim, please.
[CUSTOMER][NEUTRAL] The date of services [PII] and the bill amount $359 even.
[AGENT][NEUTRAL] OK. Yes, ma'am. We received that claim on [PII].
[AGENT][NEUTRAL] The claim was processed on [PII].
[AGENT][NEUTRAL] The claim number is 357-0637.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And the claim um denied because office visits are not covered under this policy.
[CUSTOMER][NEUTRAL] What up.
[CUSTOMER][NEUTRAL] Oh yeah
[CUSTOMER][NEUTRAL] OK. Um,
[CUSTOMER][NEUTRAL] Before that, uh, can I, uh, sorry.
[CUSTOMER][NEUTRAL] Can I, uh, can you help me out with the UB for this one?
[AGENT][NEUTRAL] Um, yes, I can fax it to you. What's your fax number, please?
[CUSTOMER][NEUTRAL] 701
[CUSTOMER][NEUTRAL] 835.
[CUSTOMER][NEUTRAL] 1020.
[AGENT][NEUTRAL] OK, one moment, please.
[CUSTOMER][NEUTRAL] Your name is [PII]?
[AGENT][NEUTRAL] It's [PII]. It's spelled [PII].
[CUSTOMER][NEUTRAL] Can you spell out it phonetically because your voice is not that clear, don't mind.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Yeah, go ahead.
[AGENT][NEUTRAL] You name it. OK, it's [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] OK, now, I, OK. Thank you so much for that.
[AGENT][POSITIVE] Oh, no problem.
[AGENT][NEUTRAL] And one moment, I'm waiting on my fax system to come up.
[CUSTOMER][NEUTRAL] Yeah, sure.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] I.
[AGENT][NEUTRAL] OK. And do I need to attention this faxed to you, to your name?
[CUSTOMER][NEUTRAL] Yes, [PII], yes, yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, [PII], you should receive it in about 10 minutes. Is there anything else I can assist you with?
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Uh, yeah, I do have other two claims.
[AGENT][NEUTRAL] Are they for the same number?
[CUSTOMER][NEUTRAL] Different number.
[AGENT][POSITIVE] OK, I'm ready for the next policy number.
[CUSTOMER][NEUTRAL] Yeah, the next policy number is going to 024.
[CUSTOMER][NEUTRAL] 44692 ML 7
[AGENT][NEUTRAL] Please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Yeah, it's
[CUSTOMER][POSITIVE] It's [PII].
[CUSTOMER][NEUTRAL] [PII] and the date of birth [PII] and the date of service [PII].
[CUSTOMER][NEUTRAL] And the bill amount $239 even.
[AGENT][NEUTRAL] OK, you said that the date of service is February, I'm sorry, you said [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And please repeat, repeat the bill charges.
[CUSTOMER][NEUTRAL] $239 even.
[AGENT][NEUTRAL] OK, I'm not showing that claim on file. Um, how was it submitted?
[CUSTOMER][NEUTRAL] It was submitted electronically.
[AGENT][NEUTRAL] Would you like to verify the payer ID?
[CUSTOMER][NEUTRAL] Yeah, one moment.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Let me check from my end it.
[CUSTOMER][NEUTRAL] The payer ID is 60801, is it?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] So there is no claim on your end, right?
[AGENT][NEUTRAL] Right. The claim can be resubmitted. Um, claims can also be faxed in. Would you like our fax number?
[CUSTOMER][NEUTRAL] So I can resubmit it, right?
[AGENT][POSITIVE] Yes, you can resubmit it.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. Would you like the fax number or you're gonna resubmit the claim through the payer ID?
[CUSTOMER][NEUTRAL] I'm gonna resubmit a pay.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Claim with the payer ID.
[AGENT][POSITIVE] OK. And I'm ready for the next policy number.
[CUSTOMER][NEUTRAL] Yeah, 1 2nd.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] Yeah, the next one is going to be uh 01666.
[CUSTOMER][NEUTRAL] 110 ML 8.
[AGENT][NEUTRAL] Thank you. Now, please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] [PII], yeah, and [PII] and the date of birth sorry [PII].
[AGENT][NEUTRAL] And what's the date of service and bill charges?
[CUSTOMER][NEUTRAL] The service is [PII] and the bill amount $277 even.
[AGENT][NEUTRAL] OK. We received this claim on [PII].
[AGENT][NEUTRAL] The claim processed on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The claim number is 357.
[AGENT][NEUTRAL] 2669 and this claim is denying because office visits are not covered under the policy.
[CUSTOMER][NEUTRAL] OK, can you help m[PII] for this one?
[AGENT][NEUTRAL] OK. Yes, ma'am. And again, your fax number is [PII].
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] No, it's [PII].
[AGENT][NEUTRAL] OK, [PII]. Attention, [PII].
[CUSTOMER][POSITIVE] That's correct. Yes. Can you please resend the previous one as well?
[AGENT][POSITIVE] Yes, ma'am, I will.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK. And then, OK. And is there anything else I can assist you with? I just sent this one. The [PII].
[CUSTOMER][NEUTRAL] The
[CUSTOMER][NEUTRAL] Mm, yeah, yes. Can I get the call reference?
[AGENT][NEUTRAL] Yes, the call reference is my name and today's date.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Have given the disclaimer before I proceed. This call is being recorded for quality and training purposes, right?
[AGENT][NEUTRAL] That's fine.
[CUSTOMER][POSITIVE] Yeah. Thank you so much for that. Have a great day. Bye-bye.
[AGENT][POSITIVE] You do the same, [PII]. Thank you for calling APL. You have a great day. Mm bye.
[CUSTOMER][NEUTRAL] Bye.