AccountId: 011433970860
ContactId: 714a624a-b68d-441d-8265-98f48e4efc3d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 404489 ms
Total Talk Time (AGENT): 130779 ms
Total Talk Time (CUSTOMER): 122877 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/05/714a624a-b68d-441d-8265-98f48e4efc3d_20250505T17:17_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yeah, hi, uh, good afternoon. My name is [PII] and last name initial [PII]. I'm calling from provider's office regarding the claim services.
[AGENT][NEUTRAL] OK, I can check on the claim for you, [PII], can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Sure. [PII]. It is a direct line.
[AGENT][NEUTRAL] Thank you. And then do you have the policy number?
[CUSTOMER][NEUTRAL] Yeah. It's 01920754 M for Mary, L for Lima, B for Bravo.
[AGENT][NEUTRAL] OK, and what was the name and date of birth for the member please?
[CUSTOMER][NEUTRAL] Yeah, it's [PII] and the date of birth [PII].
[AGENT][NEUTRAL] Perfect, thank you for verifying that. What was the date of service for this claim?
[CUSTOMER][NEUTRAL] OK. The date of service is [PII].
[CUSTOMER][NEGATIVE] And the total charge $348 even.
[AGENT][NEUTRAL] OK, that was [PII] for $340 is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK thank you one moment.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] I'm sorry, [PII], was that for $348?
[CUSTOMER][NEUTRAL] 348.
[AGENT][POSITIVE] Got it. OK, thank you.
[AGENT][NEUTRAL] OK, so we did receive this claim. Uh, we were unable to pay a benefit as office visits are not covered under this policy.
[CUSTOMER][NEUTRAL] May I know the received date and the date?
[AGENT][NEUTRAL] Yes, one moment please.
[AGENT][NEUTRAL] This claim was received [PII] and it was processed [PII].
[CUSTOMER][NEUTRAL] OK, it was received on [PII] after [PII], [PII], right?
[AGENT][NEUTRAL] The [PII].
[AGENT][NEUTRAL] 4325 is when that was processed.
[CUSTOMER][NEUTRAL] OK I know the claim number?
[AGENT][NEUTRAL] That is 358-466-1.
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Yes, can you hear me?
[CUSTOMER][NEUTRAL] Uh, sorry for the inconness. Can you please repeat again one more time the claim number?
[AGENT][NEUTRAL] That is 35.
[AGENT][NEUTRAL] 84661.
[CUSTOMER][NEUTRAL] OK. Just give me a moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Really.
[CUSTOMER][NEUTRAL] By the way, how are you doing today?
[AGENT][NEUTRAL] I'm doing all right, [PII], how are you?
[CUSTOMER][MIXED] Not bad. So today is the Monday, right? It's a boring day.
[AGENT][NEUTRAL] It is very Monday, yes.
[CUSTOMER][NEUTRAL] So I am waiting again, uh, weekend.
[AGENT][NEUTRAL] You what? I'm sorry.
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] What did you say? I'm sorry.
[CUSTOMER][NEUTRAL] I'm waiting for weekend again.
[AGENT][NEUTRAL] Oh yeah, me too, already.
[CUSTOMER][NEUTRAL] OK, thank you. So the claim number is 3584661, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK. And can you please send the UOB through fax? Why? Because I'm trying to check the UOB through portal, but in portal there is no UB phone.
[AGENT][NEUTRAL] Sure, yeah, um, what was that fax number for you?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, I'm gonna read that back to you to make sure I heard that correctly. I'm sorry?
[CUSTOMER][NEUTRAL] And also put the.
[CUSTOMER][NEUTRAL] Sure. Yeah, yeah.
[AGENT][NEUTRAL] OK, so that was [PII].
[CUSTOMER][NEUTRAL] Yes, you got it. And please put attention my name, [PII].
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] All right. I will go ahead and get that sent now. Uh, I should get it within about 10 minutes or so. Uh, was there anything else I could help you with?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] And I have one more claim under the same patient, but date of service is different.
[AGENT][NEUTRAL] OK, what was that date of service?
[CUSTOMER][NEUTRAL] OK, one second.
[CUSTOMER][NEUTRAL] Yeah. Uh, it's [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] And the dollar amount is $237 even?
[AGENT][NEUTRAL] 7. OK, thank you one moment.
[AGENT][NEUTRAL] OK, so this one, denied for the same reason, Harry, as office visits are not covered under this policy. Would you like me to send you this EOB as well?
[CUSTOMER][NEUTRAL] Yeah, and this one also need any.
[AGENT][NEUTRAL] OK, I will send that to you, and then I've got that claim number if you need that.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, that is 3561513.
[CUSTOMER][POSITIVE] OK. Thank you.
[AGENT][NEUTRAL] Of course is there anything else I can help you with?
[CUSTOMER][NEUTRAL] Uh, no, thanks. And can you please spell your name?
[AGENT][NEUTRAL] All right. Yeah, it's [PII]
[CUSTOMER][POSITIVE] Yeah. Thank you and thank you for giving this information. Have a nice day.
[AGENT][NEUTRAL] Of course.
[AGENT][POSITIVE] Absolutely, you too. Thank you. Bye-bye.
[CUSTOMER][NEUTRAL] Yeah bye bye.