AccountId: 011433970860
ContactId: 64c9f207-8018-4905-979a-639e11506936
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 314920 ms
Total Talk Time (AGENT): 117060 ms
Total Talk Time (CUSTOMER): 103070 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/13/64c9f207-8018-4905-979a-639e11506936_20250613T13:49_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. This is [PII]. I'm calling from office for looking claim status.
[AGENT][NEUTRAL] OK, well, I can definitely help you with the claim status. And can you repeat your name for me, please?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] And [PII], may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Uh, it is [PII].
[AGENT][NEUTRAL] I'm sorry, I was typing and the computer wasn't typing. Can you repeat that for me, please? My apologies.
[CUSTOMER][NEUTRAL] Uh yeah, sure. Uh [PII].
[CUSTOMER][NEUTRAL] Um, I'm sorry, [PII].
[CUSTOMER][NEUTRAL] Uh, just allow me a second. Actually, I forget that.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and how many claims do you have in total today?
[CUSTOMER][NEUTRAL] I'm sorry?
[AGENT][NEUTRAL] How many claims do you have in total today?
[CUSTOMER][NEUTRAL] Uh, it, it, I, I have a single claim.
[AGENT][NEUTRAL] OK, and may I have the member's policy number?
[CUSTOMER][NEUTRAL] Yeah, sure. Just a second.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, it is 227-97007.
[AGENT][POSITIVE] Thank you. Hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] It's uh [PII], and date of birth is [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And may I have the date of service and total bills for the claim?
[CUSTOMER][NEGATIVE] Uh, data service of [PII], and total charge is 100, uh, I'm sorry, $1820 even.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 1820.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And can you verify the name of the provider's office on the claim?
[CUSTOMER][NEUTRAL] Uh, Saint Francis, uh, Saint Francis, East Side.
[AGENT][NEUTRAL] Thank you. I'm showing the claim was received on [PII].
[AGENT][NEUTRAL] The claim number is 360.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 9054.
[CUSTOMER][NEUTRAL] think.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] And on [PII], the claim was denied, requesting the explanation of benefits from primary insurance.
[CUSTOMER][NEUTRAL] Uh, you mean the claim denied for primary will be.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Uh, just a second.
[CUSTOMER][NEUTRAL] Uh, could you provide me an email address for PrimeUB?
[AGENT][NEUTRAL] Um, we don't accept claims documents via email. You can fax the claim, mail it, or, um, send it electronically with payer ID. Which one do you prefer?
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Provide me email ID and fax number of both.
[AGENT][NEUTRAL] I can provide you with the fax number. Again, we do not accept claims documents through email. Would you like the fax number, payer ID or mailing address?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, OK. Uh, what is the fax number?
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] 94
[AGENT][NEUTRAL] 23
[AGENT][NEUTRAL] And that's attention APL?
[CUSTOMER][NEUTRAL] OK. 94.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] May I continue?
[CUSTOMER][NEUTRAL] Uh, may I have, may I have timely filing?
[AGENT][NEUTRAL] Did you need who to put the attention to for the facts?
[CUSTOMER][NEUTRAL] Yeah, you said, uh, you said uh Tencent, uh Tencent is the APL is correct?
[AGENT][NEUTRAL] Attention APL claims department.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Appeal claim department.
[AGENT][NEUTRAL] And what was your question?
[CUSTOMER][NEUTRAL] Oh, I asking you, what is your family planning?
[AGENT][NEUTRAL] There's no timely filing. um, this is additional information, so once we receive it, we'll continue processing.
[CUSTOMER][NEUTRAL] OK, there is no any time.
[CUSTOMER][POSITIVE] Uh, thank you so much. Uh, may I have
[CUSTOMER][NEUTRAL] The call reference number for this call?
[AGENT][NEUTRAL] So there's no call reference number, but you can use my name in today's date, and again, that's [PII], first initial to my last name is [PII].
[CUSTOMER][POSITIVE] OK. Thank you so much.
[AGENT][POSITIVE] You're welcome. Was there anything else I can assist you with today? Thanks for calling APL. Bye-bye.
[CUSTOMER][POSITIVE] Thank you. Have a good day.
[CUSTOMER][NEGATIVE] No thank you.
[CUSTOMER][NEUTRAL] Bye.