AccountId: 011433970860
ContactId: 73ae4086-2cd6-4182-b914-0acfc8a10406
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 282390 ms
Total Talk Time (AGENT): 91440 ms
Total Talk Time (CUSTOMER): 76541 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/06/73ae4086-2cd6-4182-b914-0acfc8a10406_20250506T14:34_UTC.wav
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[AGENT][POSITIVE] Thank you for calling APL. My name is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling for provider to check on aniline clarification. Please be informed that this call is being recorded and monitored for quality and training purposes.
[AGENT][NEUTRAL] OK, and how long is your callback number?
[CUSTOMER][NEUTRAL] That is [PII].
[AGENT][NEUTRAL] What is the policy number please, [PII]?
[CUSTOMER][NEUTRAL] Yeah, the policy ID is 02137731.
[AGENT][NEUTRAL] OK, let me just repeat that to you. I have that as 02137731.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] So the patient's name is [PII]. Date of birth was on [PII].
[AGENT][POSITIVE] Thank you very much and you're calling in regards to a denied claim, and I can assist you with that. Do you have that claim number, [PII]?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Mm, yeah, I do have the claim number. Just a moment.
[CUSTOMER][NEUTRAL] Here, the claim number is 359-0367.
[AGENT][POSITIVE] Thank you very much. One moment, please. I'll look into that for you.
[AGENT][NEUTRAL] OK, thank you. We are requesting the explanation of benefits from the primary insurance provider.
[CUSTOMER][NEUTRAL] Mm, yeah, we have already submitted that on [PII]. So could you please double check, have you received the primary EOP?
[AGENT][NEUTRAL] I'm sorry, it was resubmitted or submitted when?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, we have not received the explanation of benefits we're requesting that.
[CUSTOMER][NEUTRAL] OK. So can I verify with the primary payer, primary insurance?
[AGENT][NEUTRAL] We do not coordinate benefits, but I can check to see what is on our records possibly if it is available.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] OK, the primary insurance provider, um.
[AGENT][NEUTRAL] Let's see one moment.
[AGENT][NEUTRAL] It may be employee benefit management services.
[CUSTOMER][NEUTRAL] Uh, sorry, could you please repeat that?
[AGENT][NEUTRAL] It may be employee benefit management services.
[CUSTOMER][NEUTRAL] Yeah. Is it with the member ID ending in 2277 for the primary payer?
[AGENT][POSITIVE] I'm so sorry. Say that one more time.
[CUSTOMER][NEUTRAL] You don't have the primary insurance member ID?
[AGENT][NEGATIVE] I do not, no.
[CUSTOMER][NEUTRAL] OK. And you have a secondary insurance, right?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] Thank you. Can I get the mailing address?
[AGENT][NEUTRAL] Of course it is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] The starting is [PII]. Is that right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK. Thank you. And can I also get the timely filing limit?
[AGENT][NEUTRAL] There you're welcome. There is no timely filing limit to submit a claim.
[AGENT][NEUTRAL] Or information thereof.
[CUSTOMER][NEUTRAL] Is there a specific phone?
[AGENT][NEUTRAL] There is no time.
[CUSTOMER][NEUTRAL] Is there a specific form required?
[AGENT][NEUTRAL] No, we're only requesting the explanation of benefits.
[CUSTOMER][NEUTRAL] OK. Can I get the call reference number and your name, please?
[AGENT][NEUTRAL] My name is [PII]. We do not provide call reference numbers. You can use my name in today's date, [PII]. Anything else I can help you with?
[CUSTOMER][POSITIVE] Uh, no, thank you so much for assisting, [PII]. Have a great day. Take care. Bye for now.
[AGENT][POSITIVE] Mm thank you for calling AP. I'll take care bye.