AccountId: 011433970860
ContactId: 6498c5a2-587c-4804-a051-49677ce47e2e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 435869 ms
Total Talk Time (AGENT): 134967 ms
Total Talk Time (CUSTOMER): 173373 ms
Interruptions: 4
Overall Sentiment: AGENT=0.3, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/20/6498c5a2-587c-4804-a051-49677ce47e2e_20250620T13:58_UTC.wav
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[AGENT][NEUTRAL] APL, this is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, I'm [PII] calling from provider's office to check the claim status.
[AGENT][POSITIVE] Hi, [PII]. Happy to check on a claim for you. Can I get the patient's policy number?
[CUSTOMER][NEUTRAL] Hi [PII], I need to check on the claim for you. Can I get the patient?
[CUSTOMER][NEUTRAL] Sure, uh, the member ID is going to be 025.
[CUSTOMER][NEUTRAL] 89486.
[AGENT][NEUTRAL] And do you have a good callback number for documentation, please?
[CUSTOMER][NEUTRAL] please
[CUSTOMER][NEUTRAL] Sure, it's [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. May I have the patient's name and date of birth?
[CUSTOMER][POSITIVE] Thank you, may I have the patient to me.
[CUSTOMER][NEUTRAL] Member's name is [PII]. Date of birth will be [PII].
[AGENT][NEUTRAL] So you just service.
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] And double them on just a moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] The amount is $195 even.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] So it looks like the claim was received on.
[CUSTOMER][NEUTRAL] So it looks like the claim was received.
[AGENT][NEUTRAL] [PII]. The claim was denied on [PII]. Office visits are not covered under the member's policy.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] The
[CUSTOMER][NEUTRAL] 2
[CUSTOMER][NEUTRAL] Cover um.
[CUSTOMER][NEUTRAL] OK, can you provide me the claim number?
[AGENT][NEUTRAL] 3603508.
[CUSTOMER][NEUTRAL] OK, the claim number is 3603508, right?
[AGENT][POSITIVE] Mm. Correct.
[CUSTOMER][POSITIVE] Thank you so much and I do have
[CUSTOMER][NEUTRAL] Another
[CUSTOMER][NEUTRAL] A 3 day service for the same patient to check.
[AGENT][NEUTRAL] What's the other data service?
[CUSTOMER][NEUTRAL] What's the
[CUSTOMER][NEUTRAL] Sure, uh, the next date of service is going to be [PII], and the bill amount is $160 even.
[AGENT][NEUTRAL] Claim is received [PII]. Claim was processed on [PII]. Claim was denied, office visits are not covered under the member policy.
[CUSTOMER][NEUTRAL] The 16.
[CUSTOMER][NEUTRAL] 2
[CUSTOMER][NEUTRAL] It's 25.
[CUSTOMER][NEGATIVE] Plains out the office visits are not covered.
[CUSTOMER][NEUTRAL] All
[CUSTOMER][NEUTRAL] OK, and the claim number?
[AGENT][NEUTRAL] 360.
[CUSTOMER][NEUTRAL] 36
[AGENT][NEUTRAL] 3505.
[CUSTOMER][POSITIVE] Got it thank you so much and shall we move to the next one?
[AGENT][NEUTRAL] What's the next data service?
[CUSTOMER][NEUTRAL] 6
[CUSTOMER][NEUTRAL] Sure, it's [PII] and the bill amount is $138 even.
[AGENT][NEUTRAL] Claim is received [PII]. Claim was denied [PII].
[CUSTOMER][NEUTRAL] Claims for [PII].
[CUSTOMER][NEUTRAL] Like this [PII].
[AGENT][NEUTRAL] Office visits are not covered under the member's policy.
[CUSTOMER][NEUTRAL] Of
[AGENT][NEUTRAL] And the claim number for this is 360.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Sorry
[AGENT][NEUTRAL] 349 6.
[CUSTOMER][POSITIVE] Got it thank you.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Shall we move to the next one?
[AGENT][NEUTRAL] Next day service.
[CUSTOMER][NEUTRAL] Next
[CUSTOMER][NEUTRAL] Sure, uh, the next date of service is [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And the bill amount is $138 even.
[AGENT][NEUTRAL] Claim is received [PII]. Claim was denied [PII].
[CUSTOMER][NEUTRAL] Plays for speaking to me.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Office visits are not covered under the member policy.
[CUSTOMER][NEUTRAL] Offices are not covered under the.
[AGENT][NEUTRAL] And the claim number for this is 360.
[CUSTOMER][NEUTRAL] And the claim number for this is 360.
[AGENT][NEUTRAL] 3502.
[CUSTOMER][NEUTRAL] 3
[CUSTOMER][NEUTRAL] Got it.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] I do have one more data service for this member.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, it's [PII] and the bill amount is $160.
[AGENT][NEUTRAL] No claims on file for [PII].
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] For
[CUSTOMER][NEUTRAL] OK. And may I know the start date and end date of this policy?
[AGENT][NEUTRAL] Effective date is [PII]. Patient is still active.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][POSITIVE] So active
[CUSTOMER][POSITIVE] OK, thank you so much and.
[CUSTOMER][NEUTRAL] Uh, could you please spell out your name for me?
[AGENT][NEUTRAL] My name is spelled [PII]
[CUSTOMER][NEUTRAL] Thank you. And how much is the time of filing limit to submit I'm saying?
[AGENT][NEGATIVE] No timely filing.
[CUSTOMER][POSITIVE] I finally
[CUSTOMER][NEUTRAL] OK, and can you provide me the claim mailing address?
[AGENT][NEUTRAL] That would be [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] That's in [PII] City, [PII].
[CUSTOMER][NEUTRAL] That's it
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Zip code is [PII].
[CUSTOMER][NEUTRAL] Zip code is [PII].
[CUSTOMER][NEUTRAL] OK, got it. And uh can you provide me the payer ID?
[AGENT][NEUTRAL] 60801.
[CUSTOMER][NEUTRAL] 080.
[CUSTOMER][POSITIVE] Thank you so much and that's all for today. Can you provide me the call reference number?
[AGENT][NEUTRAL] Call reference is my name with today's date.
[CUSTOMER][POSITIVE] Got it thank you so much sir.
[AGENT][POSITIVE] You're welcome bye bye.