AccountId: 011433970860
ContactId: 70fcb6c0-da5f-4fea-adc1-1bfd91c41d03
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 284899 ms
Total Talk Time (AGENT): 86553 ms
Total Talk Time (CUSTOMER): 107914 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/16/70fcb6c0-da5f-4fea-adc1-1bfd91c41d03_20250116T17:55_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hello, [PII]. This is [PII] here, calling from the provider's office, checking on a claim.
[AGENT][POSITIVE] All right, [PII], I'm happy to check on a claim for you today. Do you have the patient's policy number?
[CUSTOMER][NEUTRAL] Uh, yeah, I do have it. It it is D as in delta 43221067.
[AGENT][NEUTRAL] Unfortunately we can't pull the patient with that number. Do you have a claim number or their name or social?
[CUSTOMER][NEUTRAL] I do have a social which is [PII].
[AGENT][NEUTRAL] All right, let me try and pull the number with that information. Give me just one moment please.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] What is the patient's name, please?
[CUSTOMER][NEUTRAL] And his name is [PII].
[AGENT][NEUTRAL] And date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you for that. And then what is the date of service?
[CUSTOMER][NEUTRAL] D of service is [PII] with the demand and the claim being $490 even.
[AGENT][POSITIVE] Thank you so much. One moment.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Alright, so it looks like we did receive a claim on [PII].
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Uh, the claim was denied.
[AGENT][NEUTRAL] Hm
[AGENT][NEUTRAL] Uh, looks like the patient plan was not active at the time of service. Patient's plan lapsed on [PII].
[CUSTOMER][NEUTRAL] OK, may I have the.
[CUSTOMER][NEUTRAL] Labs, so that means is the patient active for uh uh as of now?
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] So since then, the patient doesn't uh
[CUSTOMER][NEUTRAL] Became active?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The patient is not active, does not have an active plan with us since [PII].
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, and this is, uh, provide me the original claim number.
[AGENT][NEUTRAL] Claim number is 349-866-5.
[CUSTOMER][NEUTRAL] Alright, and what is the effective date of the policy?
[AGENT][NEUTRAL] It was [PII].
[CUSTOMER][NEUTRAL] [PII] or [PII], OK.
[CUSTOMER][NEUTRAL] All right, [PII], would you be able to fax us the copy of the remittance?
[CUSTOMER][NEUTRAL] 45
[AGENT][NEUTRAL] Uh, yeah, we can fax a copy. What's a good fax number?
[CUSTOMER][NEUTRAL] It is 833.
[CUSTOMER][NEUTRAL] 648-483-2
[AGENT][POSITIVE] OK, so I'm sending that should be there in about 5 minutes. Is there anything else I can help with here today?
[CUSTOMER][NEUTRAL] Uh, no, sir, that was the only patient I was having, and can you please put the attention to my name [PII], last name initial [PII].
[AGENT][NEUTRAL] [PII]. Yep, I sure can, [PII].
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, great. All right. All right, sir, that's the only query then. So do you have any reference number?
[AGENT][NEUTRAL] Call reference would be my name with my last initial and then today's date.
[CUSTOMER][POSITIVE] Got it, [PII]. Thank you so much for your assistance. I really appreciate your help.
[AGENT][POSITIVE] You're welcome. Have a good day.
[CUSTOMER][POSITIVE] You too bye bye take care.
[AGENT][NEUTRAL] Bye bye.