AccountId: 011433970860
ContactId: 67198b79-97a1-4ba9-8f1f-d5c0d55b18ca
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 290140 ms
Total Talk Time (AGENT): 100327 ms
Total Talk Time (CUSTOMER): 123634 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/12/67198b79-97a1-4ba9-8f1f-d5c0d55b18ca_20250212T19:17_UTC.wav
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[AGENT][POSITIVE] Thank you for calling APR. This is [PII]. How can I help?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Yeah, hi, [PII]. This is [PII] calling from Provara's office to check on all this information about the claim that has been denied. Please note this call will be monitored and recorded for quality and training purpose.
[AGENT][NEUTRAL] I'm sure, [PII]. I can assist you with claim status. Um, first, I'll need a good callback number in case we're disconnected.
[CUSTOMER][NEUTRAL] Medical
[CUSTOMER][NEUTRAL] Sure. Callback number [PII]. It's a direct line. There is no any extension.
[AGENT][NEUTRAL] Thank you. Now, I need the policy number, please.
[CUSTOMER][NEUTRAL] Sure. Policy number, it is 1084268.
[AGENT][NEUTRAL] Please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Patient name is [PII], date of birth, [PII].
[AGENT][NEUTRAL] OK, thank you. Now I need the date of service and bill charges on the claim.
[CUSTOMER][NEUTRAL] Date of [PII]. And let me get the total amount here. So the total bill amount it is gonna be $205 even $205.
[AGENT][NEUTRAL] OK. And what's the date of service one more time?
[CUSTOMER][NEUTRAL] Um [PII].
[CUSTOMER][NEUTRAL] And we got from denial or rejection stating patient is not active.
[AGENT][NEUTRAL] Um, yes, sir. That claim did deny because, um, the patient wasn't active on the date of service and just let me advise you that verification of coverage does not guarantee payment of claims. The effective date on this policy was [PII], and this policy expired on [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]. Is there any other active policy?
[AGENT][NEUTRAL] No, there isn't.
[CUSTOMER][NEUTRAL] No other active policy for the patient. OK. Thank you so much. And may I get your call reference number for this number?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Yes, for the reference number, you can use my name and today's date. My name is [PII]. It's spelled [PII] Last initial is [PII] and today's date. Is there anything else that I can assist you with?
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Yes. I just want to confirm your name, [PII]?
[AGENT][NEUTRAL] It's [PII]
[CUSTOMER][NEUTRAL] Oh, [PII] So if I do have one more member that will be my final member. Can we move to that?
[AGENT][NEUTRAL] Um, yes, one moment, please.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] No
[AGENT][POSITIVE] OK, thanks for your patience. I'm ready for the next policy number.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yes, that is gonna be 226-3337.
[AGENT][NEUTRAL] Please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Patient name is [PII]. Date of birth [PII].
[AGENT][NEUTRAL] OK, thank you. Now I need the date of service and bill charges on the claim.
[CUSTOMER][NEUTRAL] And date of [PII]. Let me get the bill charges here. So, the total amount, it is $239 even we got the same denial like the previous one.
[AGENT][NEUTRAL] Yes, sir, and just let me advise you that verification of coverage does not guarantee payment of claims. Um, I'm showing the effective date on this policy was [PII], and this policy expired on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And on [PII] and what's after this [PII]. OK. And is there any uh attractive policy?
[AGENT][NEUTRAL] No, there isn't.
[CUSTOMER][NEUTRAL] No other active policy, right? Policy, OK.
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] OK. And the call reference number as your name and today that, right? [PII]
[AGENT][NEUTRAL] Yes, and today's date.
[CUSTOMER][NEUTRAL] Yeah, what's your initial?
[AGENT][NEUTRAL] It's [PII].
[CUSTOMER][POSITIVE] [PII] and [PII] and [PII]. So, thank you. Thank you so much for your assistance, [PII]. Have a wonderful day, Avi. Bye for now.
[AGENT][NEUTRAL] OK, [PII], is there anything else that I can assist you with?
[CUSTOMER][NEUTRAL] No, thank you.
[AGENT][POSITIVE] OK. Thank you again, [PII], for calling APL. You have a great day as well. Mm bye.
[CUSTOMER][NEUTRAL] Yeah.