AccountId: 011433970860
ContactId: 7b5c2da9-2c60-471f-b5b1-87bec66fc7ec
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 482380 ms
Total Talk Time (AGENT): 118538 ms
Total Talk Time (CUSTOMER): 142311 ms
Interruptions: 2
Overall Sentiment: AGENT=0.3, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/16/7b5c2da9-2c60-471f-b5b1-87bec66fc7ec_20250416T18:10_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hello [PII], this is [PII] calling from provider's office to check up on a claim status. Also, this call has been recorded for quality and training purpose. Are you OK with that?
[AGENT][NEUTRAL] Yeah, that's fine, [PII]. I'm happy to check on a claim. Do you have the patient's policy number?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, go ahead.
[CUSTOMER][NEUTRAL] Uh, yeah, it would be 025.
[CUSTOMER][NEUTRAL] 38163.
[AGENT][NEUTRAL] And do you have a good call back number?
[CUSTOMER][NEUTRAL] Uh, it would be [PII].
[CUSTOMER][NEUTRAL] And you said your name is [PII], spelled as [PII]?
[AGENT][NEUTRAL] Mhm. Correct. And my last initial is [PII].
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Yeah, no problem. What is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] It would be [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] Thank you. And then what's the date of service?
[CUSTOMER][NEUTRAL] see
[CUSTOMER][NEUTRAL] Uh, it's [PII] together with the charge amount $500 even.
[AGENT][NEUTRAL] So we did receive this claim on [PII].
[CUSTOMER][NEUTRAL] I.
[AGENT][NEUTRAL] Claim was denied on [PII].
[AGENT][NEUTRAL] We need the explanation of benefits from the insured's primary.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Just give me a moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] And uh
[CUSTOMER][NEUTRAL] Fax number which I have, it is [PII]. That's right?
[AGENT][POSITIVE] Yes ma'am, correct.
[CUSTOMER][NEUTRAL] OK, can you help me with the claim number as well?
[AGENT][NEUTRAL] Claim number is 358.
[AGENT][NEUTRAL] 7807.
[CUSTOMER][NEUTRAL] OK, thank you. And what would be the call reference number for this number?
[AGENT][NEUTRAL] Call references my name with today's date.
[CUSTOMER][NEUTRAL] OK, sure. Uh yeah, can we move to the next number?
[AGENT][NEUTRAL] No let me notate this one and then we can check another 11 moment.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK, what's the next policy number?
[CUSTOMER][NEUTRAL] Sure. It would be 017.
[CUSTOMER][NEUTRAL] 046.
[CUSTOMER][NEUTRAL] 12
[AGENT][NEUTRAL] Patient's name and date of birth.
[CUSTOMER][NEUTRAL] Member's name would be [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] Data service.
[CUSTOMER][NEUTRAL] It's [PII]. Our charge amount $500 even.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] This claim was received on [PII].
[AGENT][NEUTRAL] Claim was denied [PII].
[AGENT][NEUTRAL] We need the insured's primary EOB.
[CUSTOMER][NEUTRAL] OK thank you uh can you help me with the claim number?
[AGENT][NEUTRAL] Claim number on this is going to be 358.
[AGENT][NEUTRAL] 1996.
[CUSTOMER][NEUTRAL] OK, thank you. uh, can we move to the next number?
[AGENT][NEUTRAL] Mhm. Go ahead.
[CUSTOMER][NEUTRAL] It would be 025.
[CUSTOMER][NEUTRAL] 42
[CUSTOMER][NEUTRAL] 056.
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] It's hello [PII].
[CUSTOMER][NEUTRAL] The date of birth is [PII].
[AGENT][NEUTRAL] Data service?
[CUSTOMER][NEUTRAL] It's [PII] total charge $500 even.
[AGENT][NEUTRAL] And the total charge amount again, I apologize.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] It's $500 even.
[AGENT][NEUTRAL] OK, so for this member, the active policy is a different number and the claim number is under a different policy. Do you want that policy number?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] 02509862
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Claim is received [PII].
[AGENT][NEUTRAL] It was denied [PII].
[AGENT][NEUTRAL] Needing an EOB from the primary.
[AGENT][NEUTRAL] Claim number is 3582089.
[CUSTOMER][NEUTRAL] Like
[CUSTOMER][NEUTRAL] 782089.
[CUSTOMER][POSITIVE] OK, thank you so much.
[CUSTOMER][POSITIVE] Thank you so much for your help.
[AGENT][NEUTRAL] Mhm. Anything else?
[CUSTOMER][POSITIVE] Uh, no, thank you so much. That's it for today. Hope you have a wonderful day. Thank you so much. Bye bye.
[AGENT][POSITIVE] Have a good day. You, you too, [PII]. Bye-bye.