AccountId: 011433970860
ContactId: 72a2210e-9bc2-4aae-aa6e-8df3f731d4b7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 421910 ms
Total Talk Time (AGENT): 87473 ms
Total Talk Time (CUSTOMER): 231913 ms
Interruptions: 2
Overall Sentiment: AGENT=0.5, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/12/72a2210e-9bc2-4aae-aa6e-8df3f731d4b7_20250512T19:37_UTC.wav
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[AGENT][NEUTRAL] Calling APL, my name is [PII]. How can I assist you today?
[CUSTOMER][NEUTRAL] Yes, my name is [PII], my last.
[CUSTOMER][NEUTRAL] For office and I'm looking for Cle. May I have your good name spell, please?
[AGENT][NEUTRAL] It's [PII] Last initial is [PII], and I'd be happy to assist with claim status today, [PII], if I can get a good call back number for you.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yeah. Hm. Yeah, sure. That is [PII].
[AGENT][NEUTRAL] And what is the policy number?
[CUSTOMER][NEUTRAL] Yes, one moment.
[CUSTOMER][NEUTRAL] Policy number is going to be 02262930 M as in Mary Lima 7.
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yes, the name is uh [PII].
[CUSTOMER][NEUTRAL] And the date of birth is [PII].
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] And your tax ID?
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Yes, tax ID is going to be [PII].
[CUSTOMER][NEUTRAL] OK, I don't know who.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Uh yes I know.
[AGENT][POSITIVE] Thank you for that information.
[AGENT][NEGATIVE] It looks as though the claim was sent several times and denied because we need the EOB from the primary insurance.
[CUSTOMER][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mm, OK.
[CUSTOMER][NEUTRAL] And uh what is the received date?
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] One moment
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] In 5.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Claim was received on [PII]. Claim denied on [PII].
[CUSTOMER][NEUTRAL] Well
[CUSTOMER][NEUTRAL] A
[CUSTOMER][NEUTRAL] Uh, [PII] and uh claim denied is need primary OB.
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] And uh.
[CUSTOMER][NEUTRAL] I have a 12345 can you check?
[CUSTOMER][NEUTRAL] We have, uh
[CUSTOMER][NEGATIVE] Uh, 55 more data service for this patient and uh all data services denied the same reason.
[AGENT][NEUTRAL] That's correct, we need the EOB.
[CUSTOMER][NEUTRAL] need to be any other inform uh other pair information for your inform?
[CUSTOMER][NEUTRAL] Well
[AGENT][NEUTRAL] No, we just need the EOB.
[CUSTOMER][NEUTRAL] OK. Primary insurance.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, uh, and, uh, this is the primary insurance, uh, OK, one moment.
[CUSTOMER][NEUTRAL] OK, thank you. Uh, can you tell me the, uh, any fax number for, uh, submitting EOB?
[AGENT][NEUTRAL] It's 877.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 365.
[AGENT][NEUTRAL] 942 3.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. Can you accept fix?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK. And uh may I have your qualify for this one?
[AGENT][NEUTRAL] Reference is just my name [PII] last [PII], and the date and time of the call. Was there anything else I could assist with today?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Well
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Uh, one moment, I'll check in my system.
[CUSTOMER][NEUTRAL] Yes, I have uh another patient.
[AGENT][NEUTRAL] What's the policy number?
[CUSTOMER][NEUTRAL] OK one moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, the policy number is going to be 01828891 and [PII] Lima number 8.
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] Uh, [PII].
[CUSTOMER][NEUTRAL] And date of birth is [PII].
[AGENT][NEUTRAL] And what's the date of service for the claim?
[CUSTOMER][NEUTRAL] Um, one moment.
[CUSTOMER][NEUTRAL] Uh, date of service is going to be [PII].
[AGENT][NEUTRAL] Thank you for that information. I'm not showing we have that claim on file. I'm also showing that this policy turned.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] On [PII], so he was not covered at the time.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]. Right.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] OK. And not uh any information for received date?
[CUSTOMER][NEUTRAL] Uh, no, uh, no claim on file?
[AGENT][NEUTRAL] No, we don't have it on file, we don't have it on file, but I was just letting you know he wasn't covered with us at the time, so.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I have another patient.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] You know
[CUSTOMER][NEUTRAL] But you have
[CUSTOMER][NEUTRAL] They're.
[AGENT][NEUTRAL] And what's the policy number?
[CUSTOMER][NEUTRAL] One moment. The policy number is uh uh no, no, it's a different policy number, so my mistake.
[CUSTOMER][POSITIVE] So thank you so much for assisting me.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Was there anything else I could assist with?
[CUSTOMER][POSITIVE] Uh, uh, no, thank you so much for assisting me. Have a nice day.
[AGENT][POSITIVE] Thank you for calling APL. Have a good day bye.
[CUSTOMER][POSITIVE] Take care bye bye.
[CUSTOMER][NEUTRAL] Bye bye.