AccountId: 011433970860
ContactId: 7bf71126-162b-4402-a999-9213928179f4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 263769 ms
Total Talk Time (AGENT): 93394 ms
Total Talk Time (CUSTOMER): 113190 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/13/7bf71126-162b-4402-a999-9213928179f4_20250313T20:12_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, good day. My name is [PII]. Last name initial is [PII] I am calling from Laboratory Corporation of America. For training and quality purposes. This line will be recorded, and I am calling regarding the status of the claim that you have submitted for one of our mutual patients. Can you please help me with it?
[AGENT][POSITIVE] Yes, ma'am. I can assist you with claim status. Can I please get your name one more time?
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] I'm calling regarding the status of the claim because we received a denial and I need the specific reason for this one.
[AGENT][POSITIVE] Yes, ma'am. I can assist you with claim status first. Could I get your name again?
[CUSTOMER][NEUTRAL] Oh yeah, sure. My name is [PII].
[AGENT][NEUTRAL] OK, thank you, [PII]. And could I get a good callback number just in case we're disconnected?
[CUSTOMER][NEUTRAL] Mhm. Good callback number is [PII].
[AGENT][NEUTRAL] Thank you, [PII]. Now, could I get the policy number, please?
[CUSTOMER][NEUTRAL] Yeah, sure, policy number is 02455589.
[AGENT][NEUTRAL] Please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK, and what's the date of service and bill charges on the claim, please?
[CUSTOMER][NEUTRAL] Date of service is [PII]. bill amount is $696.15.
[AGENT][NEUTRAL] OK, please repeat that date of service.
[CUSTOMER][NEUTRAL] Yes, sure. Date of service is [PII].
[AGENT][NEUTRAL] OK, one moment, please.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, yes, ma'am. That claim is denying because according to the primary EOB that was submitted along with the claim, the primary EOB does not, does not match the claim information. So the claim can be resubmitted with the um correct EOB primary EOB.
[CUSTOMER][NEUTRAL] All right, by any chance do you have the information for the primary insurance of the member?
[AGENT][NEUTRAL] Um, no, we don't keep that information on file. We don't have that information until we receive the claim from the provider.
[CUSTOMER][NEUTRAL] Alright, just a moment.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] May I have the mailing address?
[AGENT][NEUTRAL] Um, yes, the mailing address is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And that's in [PII].
[AGENT][NEUTRAL] And the zip code is [PII].
[CUSTOMER][NEUTRAL] All right, thank you. And what is the time wefi payment for this one?
[AGENT][NEGATIVE] There's no timely filing limit.
[CUSTOMER][NEUTRAL] Alright, thank you. And for documentation purposes, can you please spell out your first name, provide your last name initial as well as the call reference number for you please.
[AGENT][NEUTRAL] Yes, for the reference number, you can use my name and today's date. My name is [PII]. Um, it's spelled [PII] My last initial is [PII], and today's date will be your reference number. Is there anything else that I can assist you with?
[CUSTOMER][POSITIVE] That would be all AD and um I think I've got all the information that I need. I appreciate you for taking the time to answer my call and helping me with this matter. Again, this is [PII] and have a great day. Bye for now.
[AGENT][POSITIVE] Mhm. Thank you, [PII] for calling APL. You have a great day. Mm bye.
[CUSTOMER][POSITIVE] Have a great day too bye bye.
[AGENT][NEUTRAL] Bye.