AccountId: 011433970860
ContactId: 76994382-47f6-4867-96fe-04be3d45d8bb
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 374269 ms
Total Talk Time (AGENT): 133010 ms
Total Talk Time (CUSTOMER): 99684 ms
Interruptions: 1
Overall Sentiment: AGENT=0.4, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2024/12/31/76994382-47f6-4867-96fe-04be3d45d8bb_20241231T17:22_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[AGENT][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Uh hello, can you hear me?
[AGENT][NEUTRAL] I can hear you now. How may I help you? Yes. Hello?
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from the provider's office to check on a claim status.
[AGENT][NEUTRAL] Sure, I can assist you with claim status, Mr. [PII], and may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII] direct line.
[AGENT][NEUTRAL] And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] ID number is [PII].
[AGENT][NEUTRAL] That's not our policy number. Do you have the copy of the card?
[CUSTOMER][NEUTRAL] Yeah, I'm sorry. Uh, I, I have given you the tax ID. The policy number is 60801.
[AGENT][NEUTRAL] That is the payer ID.
[AGENT][NEUTRAL] Policy number is gonna start with a 0 followed by 7 digits.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] 349-937-5.
[AGENT][NEUTRAL] Is that the claim number?
[AGENT][NEUTRAL] Um, one moment. Mhm.
[CUSTOMER][NEUTRAL] Yeah, that is the claim number, but I am unable to see the policy number here. Could you please check with the patient name and date of birth?
[AGENT][NEUTRAL] One moment, let me pull that claim number, OK? One moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Just a moment.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Yeah, hello?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] What is the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Is [PII].
[AGENT][NEUTRAL] What's the date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And see
[AGENT][NEUTRAL] I'm waiting on the system, bear with me.
[CUSTOMER][POSITIVE] Sure, take your time.
[AGENT][POSITIVE] OK thank you.
[AGENT][NEUTRAL] And this is for the date of service of June, I'm sorry, yes, [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII] or [PII]?
[CUSTOMER][NEUTRAL] Uh, the bill amount is $9340.
[AGENT][NEUTRAL] OK, that's [PII], yes, correct, [PII].
[CUSTOMER][NEUTRAL] Yes, yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right, so it looks like the claim was denied and the reason for the denial is that
[AGENT][NEUTRAL] Mm, we need the EOB to process the claim.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, could you please tell me when this claim was received on?
[AGENT][NEUTRAL] OK let me see one moment.
[CUSTOMER][NEUTRAL] And may I know your name?
[AGENT][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] OK. The claim was received [PII], processed [PII].
[CUSTOMER][NEUTRAL] [PII] and [PII].
[AGENT][NEUTRAL] Process on [PII]. Receive [PII].
[CUSTOMER][POSITIVE] Yeah, thank you, thank you for this information and uh.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] How do you want to send us this primary or we do have a fax number?
[AGENT][NEUTRAL] Yes, either you can fax it or mail it. The fax number is [PII].
[CUSTOMER][NEUTRAL] [PII]. Yeah, thank you, thank you for this information. What is the attention with the blacks?
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] I'm sorry, can you repeat?
[CUSTOMER][NEUTRAL] What is the attention with the facts?
[AGENT][NEUTRAL] Um, claims department will be fine.
[CUSTOMER][NEUTRAL] Claims the Department
[AGENT][NEUTRAL] Mhm, yes.
[CUSTOMER][NEUTRAL] And uh how do you uh what is the timely time limit to some of the facts?
[AGENT][NEUTRAL] We don't have timely filing limits for you to submit additional information.
[CUSTOMER][NEUTRAL] I mean this plan will be.
[CUSTOMER][POSITIVE] OK, thank you, thank you for this information. So, and, uh, yeah, I got everything what I needed. Uh, could you please provide me the call reference number for this call?
[AGENT][NEUTRAL] I'm sorry, uh, I didn't understand what you said before that.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Call call reference number.
[AGENT][NEUTRAL] OK, we don't have a reference number so you can use my name in today's date if you will.
[CUSTOMER][POSITIVE] Mm, thank you, So um, thank you for your time and assistance and have a great day. Happy New [PII].
[AGENT][NEUTRAL] Mhm
[AGENT][POSITIVE] You as well. Thank you. You as well, Mr. [PII]. Thank you for calling APR. Have a good afternoon. Bye-bye.