AccountId: 011433970860
ContactId: 7e3d13f0-295a-4181-bd8e-e68cd3fd1d10
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 777599 ms
Total Talk Time (AGENT): 137555 ms
Total Talk Time (CUSTOMER): 277792 ms
Interruptions: 12
Overall Sentiment: AGENT=0, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/12/7e3d13f0-295a-4181-bd8e-e68cd3fd1d10_20250612T15:09_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] [PII], how can I help you? Hi, [PII]. This is [PII] calling from Global General Hospital to check on the claim status.
[AGENT][NEUTRAL] I can help you with claim status. Um, what hospital are you calling from? I'm so sorry.
[CUSTOMER][NEUTRAL] I can help you with claim status. Um, what hospital are you calling from? I'm so sorry. It's Tufts Medical Center.
[AGENT][NEUTRAL] So what's a good call back number in case we get disconnected?
[CUSTOMER][NEUTRAL] So it's a good call back number in case we get disconnected? Yeah, it's [PII] and could you please spell your name for me for my documentation purpose?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] And the initial to your last name?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][POSITIVE] Thank you so much [PII].
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Alright, and do you have the policy number with you?
[CUSTOMER][NEUTRAL] Can I proceed with the you have the policy number with you? Yeah, member ID is 02.
[CUSTOMER][NEUTRAL] 581601.
[AGENT][NEUTRAL] OK, give me just a moment while I look that up.
[CUSTOMER][NEUTRAL] Give me just a moment while I look that up.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Can you verify the patient's name and date of birth for me please?
[CUSTOMER][NEUTRAL] Can you verify the patient's name and date of birth for me please? Yeah, the patient name is [PII] and the date of birth is [PII].
[AGENT][POSITIVE] Thank you so much for verifying that with me, give me just one moment.
[CUSTOMER][POSITIVE] So much for verifying that with me. Thanks.
[AGENT][NEUTRAL] Do you have the claim number or the date of service?
[CUSTOMER][NEUTRAL] Do you have the claim number or the date of service? Yeah, the date of service is uh [PII].
[CUSTOMER][NEUTRAL] Of 2025.
[CUSTOMER][NEUTRAL] And the bill amount is $361 even.
[AGENT][NEUTRAL] All right, give me just a moment.
[CUSTOMER][NEUTRAL] OK just a moment.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Alright, can I get that.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I don't have
[CUSTOMER][NEUTRAL] Hello [PII], are you there?
[AGENT][NEUTRAL] Yes, I am just looking up that claim for you.
[CUSTOMER][NEUTRAL] Yes, I am just looking at that claim for you.
[AGENT][NEUTRAL] It looks like we received this claim on [PII].
[CUSTOMER][NEUTRAL] It looks like we received this claim on [PII].
[AGENT][NEUTRAL] It was processed on [PII].
[CUSTOMER][NEUTRAL] It was processed on [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The claim number is 3,591,570.
[CUSTOMER][NEUTRAL] The claim number is 3591.
[CUSTOMER][NEUTRAL] 570.
[CUSTOMER][NEUTRAL] 70
[AGENT][NEGATIVE] And it looks like it was denied.
[CUSTOMER][NEUTRAL] I just want to confirm the claim number is 35 was denied.
[AGENT][NEUTRAL] Go ahead.
[CUSTOMER][NEUTRAL] Yeah, just want to confirm the claim number 3,591,570. Am I right?
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] Yes sir.
[CUSTOMER][NEUTRAL] OK, and the claim was denied?
[AGENT][NEUTRAL] The claim was denied. Uh, we need a copy of the explanation of benefits from the primary insurance carrier.
[CUSTOMER][NEUTRAL] The claim was denied. Uh, we need a copy of the explanation of benefits from the primary insurance carrier.
[CUSTOMER][NEUTRAL] OK. In this case, uh, you are the secondary for the member.
[AGENT][NEUTRAL] Yes, we are the secondary.
[CUSTOMER][NEUTRAL] Yes, we are secondary. And may I know the primary details uh.
[AGENT][NEUTRAL] Give me just a moment, let me look that up.
[CUSTOMER][NEUTRAL] Who is the primary for the man just a moment let me yeah.
[AGENT][NEUTRAL] E V H C.
[CUSTOMER][NEUTRAL] E V H C
[CUSTOMER][NEUTRAL] Let see.
[CUSTOMER][NEUTRAL] Is it the payer name?
[AGENT][NEUTRAL] I'm sorry, what was that?
[CUSTOMER][NEUTRAL] I'm sorry, what was that? Uh, is it the provider, sorry, payer name that you are telling? EVHC?
[AGENT][NEUTRAL] That's their primary insurance carrier.
[CUSTOMER][NEUTRAL] That's their primary insurance carrier. OK, do you have any other details like the member ID and other details?
[AGENT][NEUTRAL] No, you'll need to get that from the uh insured.
[CUSTOMER][POSITIVE] Uh, no, you'll need to get that from the, uh, insured. OK. Thank you so much for that.
[CUSTOMER][NEUTRAL] OK. Yeah, if you don't mind, could you please fax the UP with us?
[AGENT][NEUTRAL] Give me just a moment.
[CUSTOMER][NEUTRAL] Give me just a moment.
[AGENT][NEUTRAL] Who would you like the attention to go to?
[CUSTOMER][NEUTRAL] Who would you like the attention to go to? Yeah, my my name [PII].
[CUSTOMER][NEUTRAL] Spelled as [PII] and the initial to my last name is [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And what is the fax number?
[CUSTOMER][NEUTRAL] And what is the fax number? Yeah, the fax number is [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] I have [PII].
[AGENT][NEUTRAL] [PII], correct?
[CUSTOMER][NEUTRAL] That's [PII].
[CUSTOMER][POSITIVE] [PII], correct? Yeah, that's correct.
[AGENT][NEUTRAL] Yeah, I just sent that over to you.
[CUSTOMER][NEUTRAL] Yeah, I just sent that over to you. OK, may I know the turnaround time?
[AGENT][NEUTRAL] Uh you should receive the fax um within an hour or so.
[CUSTOMER][NEUTRAL] Uh you should receive the fax um within an hour or so. OK.
[AGENT][NEUTRAL] Is there anything else I can help you with?
[CUSTOMER][NEUTRAL] Is there anything else I can help you with?
[CUSTOMER][NEUTRAL] Yeah, could you please provide me the call reference number?
[AGENT][NEUTRAL] So we don't have call reference numbers, but you can use my name and last initial in today's date. So [PII] in today's date.
[CUSTOMER][NEUTRAL] So we don't have call reference numbers that you can use my name.
[CUSTOMER][POSITIVE] And last initial and today's date, so [PII] and today's date. thank you so much.
[CUSTOMER][NEUTRAL] And I do have one more client with me for the same member um just want to know the details of the claim.
[AGENT][NEUTRAL] What was the date of service?
[CUSTOMER][NEUTRAL] What was the date of service? Yeah, the date of service is for [PII].
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] One moment.
[AGENT][NEGATIVE] It looks like it was denied for the same reason.
[CUSTOMER][NEUTRAL] Looks like it was denied for the same reason. OK, thanks so much. May I know the received date and the process date and the claim number?
[AGENT][NEUTRAL] Give me just a second.
[CUSTOMER][NEUTRAL] Give me just a second.
[AGENT][NEUTRAL] It looks like we received this claim on [PII].
[CUSTOMER][NEUTRAL] It looks like we received this claim on [PII]. We processed this claim on [PII].
[AGENT][NEUTRAL] We processed this claim on [PII].
[AGENT][NEUTRAL] And the claim number is 3591565.
[CUSTOMER][NEUTRAL] And the claim number is 35.
[CUSTOMER][NEUTRAL] 91
[CUSTOMER][NEUTRAL] 565.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, uh, could you please fax the UOB uh for the same fax number?
[AGENT][NEUTRAL] Give me just a moment.
[CUSTOMER][NEUTRAL] Give me just a moment.
[AGENT][NEUTRAL] And I just sent that over.
[CUSTOMER][NEUTRAL] And I just sent that over.
[CUSTOMER][POSITIVE] Yeah, thank you so much for that.
[CUSTOMER][POSITIVE] Yeah, I got sufficient information from you, [PII]. Thank you so much. It was a pleasure speaking to you. I have a great day. Bye bye.
[AGENT][POSITIVE] Thank you for calling ATL. Have a great day.
[CUSTOMER][POSITIVE] Thank you for calling APL. Have a great day.