AccountId: 011433970860
ContactId: 6b1577b3-f7b7-4886-8634-be35ec6d0650
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 357730 ms
Total Talk Time (AGENT): 98384 ms
Total Talk Time (CUSTOMER): 148935 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=1.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/22/6b1577b3-f7b7-4886-8634-be35ec6d0650_20250522T21:12_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hey, [PII]. This is [PII] calling from provider's office. My first name is [PII] and last initial is [PII]. And how are you doing today?
[AGENT][NEUTRAL] I am fine and how may I assist you today, [PII]?
[CUSTOMER][NEUTRAL] Alright, so I want to know a clear status for an AP member. Could you please help me with that?
[AGENT][NEUTRAL] Sure, I can verify claim status for you. And what is the policy number?
[CUSTOMER][NEUTRAL] Alright, just a moment.
[CUSTOMER][NEUTRAL] All right. So the policy number is going to be 01942482 M as in Mike, L as in Lima 8.
[AGENT][NEUTRAL] OK, thank you. And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] Yeah, sure, so the callback number is going to be [PII] and [PII], can I get your last initial?
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And [PII], what is the patient's name, date of birth?
[CUSTOMER][NEUTRAL] All right. OK.
[CUSTOMER][NEUTRAL] Yeah, sure, sir. The patient name is going to be [PII] with the date of birth [PII].
[AGENT][NEUTRAL] OK, and what was the date of service amount of the charge?
[CUSTOMER][NEUTRAL] All right, so the date of service is for [PII] with charge amount $354.42.
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] OK, and the name of the provider's office?
[CUSTOMER][NEUTRAL] Yeah, the provider of name is going to be [PII] Children's Pediatric specialist.
[AGENT][NEUTRAL] OK, moment.
[AGENT][NEUTRAL] And while I'm looking up claim information, just to let you know, we do have an online service center where providers can check claim status as well as print out the EOB. That site is at [PII]
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And I show this claim process visits are not covered for the patient's policy.
[CUSTOMER][NEUTRAL] Uh, uh, could you please uh repeat once again? What was that?
[AGENT][NEUTRAL] The claim process as office visits are not covered per the policy.
[CUSTOMER][NEUTRAL] All right. Uh, as per, um, a member's plan or provider's plan?
[AGENT][NEUTRAL] For the patient's policy with our company, office visits are not covered.
[CUSTOMER][NEUTRAL] For the patient plan, right? All right. So we need to build this claim to patient, right? As it is not covered under the patient plan?
[AGENT][NEUTRAL] Well, we can get patient responsibility. We can only verify how the claim was processed.
[AGENT][NEUTRAL] Meaning you would need to contact the patient.
[CUSTOMER][NEUTRAL] All right. OK.
[CUSTOMER][NEUTRAL] All right. Could you please provide me with the receipt date and finalized date?
[AGENT][NEUTRAL] Uh, the received date [PII], process on [PII].
[CUSTOMER][NEUTRAL] Alright, and what's the claim number going to be?
[AGENT][NEUTRAL] 355-5895.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 355-5895. All right. OK. So, uh, uh, [PII], I don't have the EOB with me, so could you please uh fax the EOB to our fax number?
[AGENT][NEUTRAL] Sure, what's the fax number?
[CUSTOMER][NEUTRAL] All right. Just a moment. Let me provide you the fax number. All right, so the fax number is going to be [PII].
[AGENT][NEUTRAL] OK, and that's [PII]?
[CUSTOMER][NEUTRAL] Yes, and the attention will be given to my uh name. Uh uh and before that, the, uh, uh, it would, it should be the PCN or the uh invoice number which is going to be 28863981.
[AGENT][NEUTRAL] OK, invoice number 28863981?
[CUSTOMER][NEUTRAL] Yes, that will be given to that name as well as my name. All right?
[AGENT][NEUTRAL] OK. Uh, is there anything else I can assist you with today?
[CUSTOMER][POSITIVE] Uh, no, thank you so much for your helped a lot by providing me with this information. And yeah, could you please provide me with the conference number?
[AGENT][NEUTRAL] Uh, if you like, you may use my name in today's date.
[CUSTOMER][POSITIVE] All right. OK. Thank you so much for that information, [PII], and have a good day. All right. Stay safe. Bye for now. And could you please provide me with the information that, yeah, what's the term, the turnaround time to get the UB?
[AGENT][POSITIVE] You're welcome.
[AGENT][POSITIVE] Hopefully in a few moments.
[CUSTOMER][POSITIVE] OK. All right. Thank you so much.
[AGENT][NEUTRAL] OK, and is there anything else I can assist you with today?
[CUSTOMER][POSITIVE] No, thank you so much. You helped a lot.
[AGENT][POSITIVE] OK, thank you for calling APL. Have a great day.
[CUSTOMER][NEUTRAL] Yeah, you too. Bye-bye.
[AGENT][NEUTRAL] Bye.
[CUSTOMER][NEUTRAL] Mhm.