AccountId: 011433970860
ContactId: 79f124d4-fc7c-4126-bfac-d33d20cd229b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 454359 ms
Total Talk Time (AGENT): 160010 ms
Total Talk Time (CUSTOMER): 344744 ms
Interruptions: 24
Overall Sentiment: AGENT=0.2, CUSTOMER=-0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/30/79f124d4-fc7c-4126-bfac-d33d20cd229b_20250130T13:28_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] APL, this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Let me.
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from the provider's office to check the claim status.
[AGENT][POSITIVE] OK, I can help you. Can you spell your name?
[CUSTOMER][NEUTRAL] OK, I can help you. Can you spell your name? OK. My name is [PII].
[AGENT][NEUTRAL] OK, thank you, [PII]. What's the policy number?
[CUSTOMER][NEUTRAL] OK, thank you. What's the policy number? Uh, can you spell out your name, first name? [PII]
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] First initial last name is [PII]
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] OK. Last name is [PII], first name is [PII] in
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] First name is [PII], first initial of my last name is [PII]
[CUSTOMER][NEUTRAL] First name is [PII] First name is spell my last name is [PII] Can you repeat it once again, your first name?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Slowly.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Yes, and can I get the policy number of [PII]?
[CUSTOMER][NEUTRAL] Yes, and can I get the policy number back? A member's ID number.
[CUSTOMER][NEUTRAL] Are you asking the member's ID number?
[AGENT][NEUTRAL] The policy number, yes.
[CUSTOMER][NEUTRAL] The policy number, yes. OK, the member ID number is 02473288.
[AGENT][NEUTRAL] Can you repeat that [PII]? You're cutting out.
[CUSTOMER][NEUTRAL] Can you repeat that that far? You're cutting out. OK. 02473288.
[AGENT][NEUTRAL] OK, and what's a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] OK, and what's the good phone number in case we're disconnected? Callback number is [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII] Yes.
[AGENT][NEUTRAL] OK, thank you. And what's the patient's name and date of birth?
[CUSTOMER][NEUTRAL] OK, thank you. And what's the patient's name and date of birth? Patient's name is [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII] and date of birth is [PII].
[AGENT][NEUTRAL] And her, her date of birth?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Thanks for verifying [PII], and you said that you're checking claims status.
[CUSTOMER][NEUTRAL] Thanks for verifying that far and you said that you're checking claims Status? OK.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] The date of service and total charge?
[CUSTOMER][NEUTRAL] The data service and total charge one seater.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Uh, date of service is uh [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] No, [PII].
[CUSTOMER][NEUTRAL] [PII] [PII] [PII].
[AGENT][NEUTRAL] Through [PII].
[CUSTOMER][NEUTRAL] [PII]. I thought, I thought you gave me a 3 day.
[AGENT][NEUTRAL] Oh, I thought, I thought you gave me a through date.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII] or [PII]?
[CUSTOMER][NEUTRAL] [PII] or [PII]?
[CUSTOMER][NEUTRAL] I'm telling you sir date of service is [PII].
[CUSTOMER][NEUTRAL] 3123.
[CUSTOMER][NEUTRAL] 3rd [PII].
[AGENT][NEUTRAL] OK, I was wanting the through date, so you said it's through [PII]. 1 moment.
[CUSTOMER][NEUTRAL] OK, I was wanting the through date, so you said it's through [PII]. 1 moment.
[AGENT][NEUTRAL] And what is the total charge?
[CUSTOMER][NEUTRAL] And what is the total charge? $99.
[AGENT][NEUTRAL] OK, so I've located date of service [PII].
[CUSTOMER][NEUTRAL] [PII] no, no, [PII], let's say [PII]. OK.
[AGENT][NEUTRAL] [PII] in the amount of $909.
[AGENT][NEUTRAL] I've, I've located the claim [PII]. That's OK. I have it.
[AGENT][NEUTRAL] Uh, show that the claim was received.
[AGENT][NEUTRAL] The claim was received on [PII].
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] Process [PII].
[CUSTOMER][NEUTRAL] Process [PII]. OK.
[AGENT][NEUTRAL] And the total and I show that we're needing a copy of the primary explanation of benefits.
[CUSTOMER][NEUTRAL] And a copy of the explanation.
[CUSTOMER][NEUTRAL] Oh yeah, for this, uh, claim in my hand, there is no showing uh you will be for this claim. What is the allowed and paid amount for this claim?
[AGENT][NEUTRAL] OK, it's on the claim that it was, it's on the primary EOB that we don't have, so I had a, I don't have that information.
[CUSTOMER][NEUTRAL] OK, it's on the claim that it was, it's on the primary EOV that we don't have, so I had, I don't have that information. Oh, you don't have allowed and paid amount for this claim?
[AGENT][NEGATIVE] We've not res we've not received the primary explanation of benefits.
[CUSTOMER][NEUTRAL] We've not we've not received the primary explanation. OK. Can you have the claim number?
[AGENT][NEUTRAL] That claim number is 351-8482.
[CUSTOMER][NEUTRAL] Please slowly, slowly slowly repeat once again from starting. OK.
[AGENT][NEUTRAL] 351
[AGENT][NEUTRAL] 8482.
[CUSTOMER][NEUTRAL] 8488482.
[AGENT][NEUTRAL] And I also see that the date of service on the claim is through [PII], not [PII].
[CUSTOMER][NEUTRAL] And I also see that the date of service on the claim is through [PII], not [PII].
[CUSTOMER][NEUTRAL] What?
[AGENT][NEUTRAL] I'm looking at the claim that we received.
[CUSTOMER][NEUTRAL] I'm at [PII]. OK, this is the that is the date of [PII].
[AGENT][NEUTRAL] It's from [PII] on the claim.
[AGENT][NEUTRAL] And what I'm saying to you, [PII], is that on the claim, it says [PII]. It doesn't say [PII].
[CUSTOMER][NEUTRAL] OK. Your claim received on [PII].
[CUSTOMER][NEUTRAL] Claimly on which later.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Uh, process on [PII].
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] There is no, uh, in your side, there is no showing allowed and paid amount for this claim.
[AGENT][NEUTRAL] We have not received, we need a copy of the primary explanation of benefits.
[CUSTOMER][NEGATIVE] We have not received. We need a copy of the primary explanation of benefits.
[CUSTOMER][NEGATIVE] In my hand also there is in my hand also there is no U for uh received for this claim.
[AGENT][NEUTRAL] And that's where that information is housed.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] I'm, I'm asking, I'm called to you and asking what is the reason of uh reason uh what is the delay of reason you will be.
[CUSTOMER][NEUTRAL] But need to receive.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] When this, when for this claim will be received? I'm asking for the OB.
[CUSTOMER][NEUTRAL] What is the reason for the delay of the OB?
[AGENT][NEUTRAL] Now we're requesting the primary explanation of benefits from your office.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No, claim number is 3518482.
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Can we check your portal?
[CUSTOMER][NEUTRAL] Portal.
[AGENT][NEUTRAL] We've not received the explanation of benefits from the primary are you referring to the APL explanation?
[CUSTOMER][NEUTRAL] We've not received the explanation of benefits from the primary. Are you referring to the ATL explanation?
[CUSTOMER][NEUTRAL] Yes I'm asking about the explanation of benefits for this claim. Why it is not explanation of benefits? What is the reason I am asking?
[AGENT][NEUTRAL] OK.
[AGENT][NEGATIVE] OK, I'm having a hard time understanding your questions. Can I speak with your supervisor?
[CUSTOMER][NEGATIVE] OK, I'm having a hard time understanding your question. Can I speak with your supervisor?
[CUSTOMER][NEUTRAL] OK.