AccountId: 011433970860
ContactId: 67b3c634-b2e7-49ee-9743-9ca16033bd0c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 193490 ms
Total Talk Time (AGENT): 90762 ms
Total Talk Time (CUSTOMER): 54839 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/15/67b3c634-b2e7-49ee-9743-9ca16033bd0c_20250415T13:12_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], I'm calling about um a claim. It was denied you need you need something. I'm not sure what you need.
[AGENT][NEUTRAL] OK, um, well, 1st may I have your name and are you the insured or your provider?
[CUSTOMER][NEUTRAL] Provider
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] And what else do you need?
[AGENT][NEUTRAL] Your name and a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, your name and the member's policy number?
[CUSTOMER][NEUTRAL] I need you.
[CUSTOMER][NEUTRAL] The policy number is 023893887.
[AGENT][NEUTRAL] 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] Um,
[CUSTOMER][NEUTRAL] [PII] [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 the total bill for the claim you like me to take a look at?
[CUSTOMER][NEUTRAL] 9912 or 2024 total bill amount $158.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] 158.
[AGENT][NEUTRAL] OK, can you verify the name of the provider's office on the claim?
[CUSTOMER][NEUTRAL] MUSC MUSC physicians.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] Alright, so I'm sure we received the claim on [PII].
[AGENT][NEUTRAL] That claim number is 357-7640.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] And on [PII], the claim was denied requesting the explanation of benefits from primary insurance.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] What do you need them? How do you want them? How would you receive them?
[AGENT][NEUTRAL] Um, you can fax it, you can mail it, or you can send it to us electronically. Um, which one would you like? Or I can give you all three if you need.
[CUSTOMER][NEUTRAL] You said fax, mail, or electronically. I would rather fax.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Fax, OK. So it's phone number [PII] or fax number, sorry, [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And then
[CUSTOMER][NEUTRAL] Attention anything?
[AGENT][NEUTRAL] Mhm. Attention APL claims department.
[CUSTOMER][NEUTRAL] APO claims department.
[CUSTOMER][NEUTRAL] OK, can I get a call reference [PII]?
[AGENT][NEUTRAL] Sure, so there's no call reference number, but you can use my name in today's date. Um, so the first initial to my last name is [PII], and my first name is [PII]
[CUSTOMER][POSITIVE] OK thank you you have a great day.
[AGENT][NEUTRAL] You're welcome, [PII]. Was there anything else I can assist you with today?
[CUSTOMER][NEUTRAL] That'll be all.
[AGENT][POSITIVE] All right, thanks for calling APL. Have a great day.
[CUSTOMER][POSITIVE] You too thanks.
[AGENT][POSITIVE] Thank you.