AccountId: 011433970860
ContactId: 74858db2-3527-4532-abbb-7beee7fcd370
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 425600 ms
Total Talk Time (AGENT): 107506 ms
Total Talk Time (CUSTOMER): 116327 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/14/74858db2-3527-4532-abbb-7beee7fcd370_20250214T17:09_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII] calling from provider's office to check up on your claim status. Could you please help me on that?
[AGENT][NEUTRAL] I'm sorry, may I have your name again?
[CUSTOMER][NEUTRAL] Yeah. It's [PII]. Uh, meanwhile, I do miss your name. Could you please spell your name for me?
[AGENT][NEUTRAL] My name is [PII], that's [PII], last initials [PII]
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] May I know your last name?
[CUSTOMER][POSITIVE] Yeah. Thank you so much for that.
[AGENT][NEUTRAL] Thank you. What is your callback number if disconnected please?
[CUSTOMER][NEUTRAL] Yeah, it's [PII].
[AGENT][NEUTRAL] What is the policy number please?
[CUSTOMER][NEUTRAL] So, just a moment, uh.
[AGENT][POSITIVE] When is I'm sorry, OK, of course, thank you.
[CUSTOMER][NEUTRAL] Yeah, I could not. Just a moment. I will go and check in insurance's card.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Just a moment. I'm checking.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, just a moment, uh, insurance card was uh not clear.
[AGENT][NEUTRAL] Would you like to give us a call back once you have the information?
[CUSTOMER][NEUTRAL] No, just a moment, just a moment. Uh.
[CUSTOMER][NEUTRAL] Uh, is there any other details you require, uh, I can provide it uh.
[CUSTOMER][NEUTRAL] Meanwhile, uh, I'm checking the details.
[AGENT][NEUTRAL] OK, what is the patient's last name?
[CUSTOMER][NEUTRAL] Yeah, it's uh [PII].
[AGENT][NEUTRAL] I'm sorry, can you spell that for me?
[CUSTOMER][NEUTRAL] Yeah, sure.
[CUSTOMER][NEUTRAL] It's
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Is that the first name or the last name?
[CUSTOMER][NEUTRAL] Uh, this is the first name.
[CUSTOMER][NEUTRAL] And last name was [PII]
[AGENT][NEUTRAL] What is the last name?
[AGENT][NEUTRAL] I'm sorry spell that again for me.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] What, what is the patient's date of birth? I do not show the person or the system.
[AGENT][NEUTRAL] What's the date of birth?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, patient's date of birth was uh [PII].
[AGENT][NEUTRAL] OK, I don't show that number on our system.
[AGENT][NEUTRAL] Were you able to get
[AGENT][NEUTRAL] To view the image of the insurance card.
[CUSTOMER][NEUTRAL] Yeah, I have the insurance card, but the insurance card, the, what the member ID was not clear, uh, that's the reason I could not be able to say. And meanwhile, uh, previously we have already follow up on this claim, uh uh.
[CUSTOMER][NEUTRAL] Uh, with the claim number.
[AGENT][NEUTRAL] OK, do you have any other information from the previous, OK, what is that claim number, please? Thank you.
[CUSTOMER][NEUTRAL] Yeah, yeah. It's 3557496.
[AGENT][NEUTRAL] OK, that was 355-7496. 1 moment.
[CUSTOMER][NEUTRAL] Yeah, sorry. It's a duplicate claim and the original claim number was, right, uh, 353.
[CUSTOMER][NEUTRAL] 976 8.
[AGENT][NEUTRAL] OK, let me repeat that. That was 353-9768. Is that correct?
[CUSTOMER][NEUTRAL] Yeah, yes, is it correct?
[AGENT][NEUTRAL] OK thank you one moment please.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, I have that initial claim number pulled up and it shows that procedure code 99214 was denied as office visits are not covered by the policy.
[AGENT][NEUTRAL] And what information would you need in addition to that, please? Yes.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] Yeah, thank you so much, [PII], for that. Uh, uh, could you please fax that to Denali will be to my fax number?
[AGENT][NEUTRAL] And Ebs can be
[AGENT][NEUTRAL] I actually obtained on our website that's [PII], but what is your fax number? I can fax it over to you.
[CUSTOMER][NEUTRAL] Yeah, it's [PII].
[AGENT][NEUTRAL] And let me repeat that to confirm. I have that as [PII].
[CUSTOMER][NEUTRAL] Yes, right.
[AGENT][NEUTRAL] OK, I will get that faxed over to you and also for claim status you're also able to check on that website as well. Anything else I can assist you with, please, [PII]?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Yeah, nothing. Thank you so much for that, [PII], for helping me today. Could you please forward me the card number for our call?
[AGENT][POSITIVE] OK, we do not provide call reference numbers right. You can use my name in today's date, and we thank you for calling us APL. Have a good day.
[CUSTOMER][POSITIVE] Yeah thank you so much have a nice day bye bye.
[AGENT][NEUTRAL] You too bye bye.