AccountId: 011433970860
ContactId: 69a15e78-d194-48d6-bf7e-bdd791c57b91
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 277200 ms
Total Talk Time (AGENT): 134202 ms
Total Talk Time (CUSTOMER): 79505 ms
Interruptions: 1
Overall Sentiment: AGENT=0.4, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/04/69a15e78-d194-48d6-bf7e-bdd791c57b91_20250204T19:34_UTC.wav
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[AGENT][NEUTRAL] Afternoon. Thank you for calling APL. This is [PII]. How may I help you today?
[CUSTOMER][NEUTRAL] Hello, we received a letter from you guys. Um, it's regarding a denied claim. Can you check claim for me?
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] I sure will. Go ahead and give me your name and the member's policy number.
[CUSTOMER][NEUTRAL] Yeah, my name is [PII] Policy number 02346482.
[AGENT][NEUTRAL] Alright, now, thank you for all that information. Now, while I'm pulling this up, go ahead and give me a good return telephone call number, please, ma'am.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Telephone number [PII].
[AGENT][NEUTRAL] Alrighty, thank you for that information. Now, what is your patient's name and date of birth of the patient you're checking status on, please, ma'am?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] [PII]. The total bill is 744.
[AGENT][NEUTRAL] OK, and what's your patient's date of birth?
[AGENT][NEUTRAL] A name.
[CUSTOMER][NEUTRAL] Um, the date, the date of birth, [PII], [PII].
[AGENT][NEUTRAL] Alrighty, is it [PII], thank you for that information. OK, you said the data service is 12-18-2024. How much is your total bill?
[CUSTOMER][NEUTRAL] 744.
[AGENT][NEUTRAL] Alrighty, give me just a moment, let's see if I can.
[AGENT][NEUTRAL] Find it, let's see.
[AGENT][NEUTRAL] Um
[AGENT][NEUTRAL] Where's your bill from?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Sorry, say that again.
[AGENT][NEUTRAL] Yeah, the bill, where's your bill from? What provider's office?
[CUSTOMER][NEUTRAL] Uh, the orthopedic center.
[AGENT][NEUTRAL] OK, that's what I needed. OK.
[CUSTOMER][NEUTRAL] I do have the claim number and
[AGENT][NEUTRAL] Mhm, yes ma'am, it looks like we do have your claim in house. Now we have requested some information from this patient's employer. So once we do receive that information from his employer.
[CUSTOMER][NEUTRAL] Oh yeah.
[AGENT][NEUTRAL] Because then your claim
[CUSTOMER][NEUTRAL] Hello. Sorry, the line is cutting in and out. Hello?
[AGENT][NEUTRAL] That's OK. Uh, yes ma'am, we have requested some information from Mr. [PII]'s employer. So once we receive that information and update our system, then your claim will be released at that time.
[CUSTOMER][NEUTRAL] Uh, is the member also notified or can we notify the member?
[AGENT][NEUTRAL] Yes, the member has been notified he gets an EOB as well.
[CUSTOMER][NEUTRAL] Uh, OK. And this was sent on [PII], correct?
[AGENT][POSITIVE] That is correct. Yes, ma'am.
[CUSTOMER][NEUTRAL] OK. So how long are you giving them time to respond? Like they have 10 days?
[AGENT][NEUTRAL] There's not a time limit just when the when the employer usually they get back with us pretty quick um so probably hopefully it'll be done within uh this week then or early next week.
[AGENT][NEUTRAL] I would just say call back and if you have not received your payment or EOB uh releasing this claim just give us a call back in about 7 to 10 working days so let's make sure.
[CUSTOMER][NEUTRAL] OK, can I have your name again?
[AGENT][NEUTRAL] Yes, ma'am. My name is [PII]. That is [PII] yes, and is that all that I can answer for you today?
[CUSTOMER][NEUTRAL] Uh, the call reference number is your name also, right?
[AGENT][NEUTRAL] Yes ma'am my name in today's date because we actually don't give call reference numbers all right?
[CUSTOMER][POSITIVE] OK. Thank you so much. Have a good one.
[AGENT][POSITIVE] Yes, ma'am. You as well, [PII]. Thanks for calling APL. Have a great day. Bye-bye.
[CUSTOMER][NEUTRAL] Mhm.