AccountId: 011433970860
ContactId: 88e0e58a-01d0-4a80-b5cc-09181334aa42
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 230559 ms
Total Talk Time (AGENT): 126333 ms
Total Talk Time (CUSTOMER): 68182 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/06/88e0e58a-01d0-4a80-b5cc-09181334aa42_20250106T18:41_UTC.wav
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[AGENT][NEUTRAL] Afternoon, thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh, yes, I'm a provider of service. I just need to check status of a claim.
[AGENT][NEUTRAL] OK, your name and claim status for a member, is that correct?
[CUSTOMER][NEUTRAL] Yes, yes.
[AGENT][POSITIVE] Yes, I can help you with that and who am I speaking with please?
[CUSTOMER][NEUTRAL] Um, [PII] with Columbus Regional Health Physicians.
[AGENT][NEUTRAL] OK, thank you and [PII], what is your callback number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you and the member's policy number please?
[CUSTOMER][NEUTRAL] It is 02502255.
[AGENT][POSITIVE] Thank you, one moment.
[AGENT][NEUTRAL] And I and any information that I do provide for you today will be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII] and it's [PII].
[AGENT][NEUTRAL] OK, thank you. And what is the date of service and total bill amount, please?
[CUSTOMER][NEUTRAL] It's [PII] $5,522.
[AGENT][NEUTRAL] One more time on the total bill amount.
[CUSTOMER][NEUTRAL] 5,522.
[CUSTOMER][NEUTRAL] 5522.
[AGENT][NEUTRAL] Yes, OK.
[AGENT][NEUTRAL] OK, so this claim I can see it was received back in [PII] and processed the same date and denied.
[AGENT][NEUTRAL] The claim number is 3526586.
[AGENT][NEUTRAL] The remark on this claim states our records indicate that premium for this service state was not received. Therefore benefits are not payable.
[CUSTOMER][NEUTRAL] Oh, OK, OK, because I had called previously and they said, oh well that place of service is payable, but OK, I got it, so it's premium.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] Yes, we have not correct. We did not receive premium to cover that data service.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, that's no problem.
[AGENT][NEUTRAL] Now, and I don't know if when you called before you were given our website, um, [PII] that you can go to to print a copy of the EOB if you need that, but you can set up your own username and password by going to [PII].
[AGENT][NEUTRAL] And, and you should be able to print that EOB if you need a copy of it.
[CUSTOMER][NEUTRAL] OK, um [PII]?
[AGENT][NEUTRAL] Yes ma'am, that's it.
[CUSTOMER][NEUTRAL] OK, it's not OK is it secure at AM Public?
[AGENT][POSITIVE] Yeah, it's just secure.
[AGENT][MIXED] Secured but with a D on it uh-huh.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][POSITIVE] OK, OK, I got you.
[AGENT][NEUTRAL] Just, just type in [PII] not a don't put [PII] with it, just secured. [PII] and it will pull it up.
[CUSTOMER][NEUTRAL] OK, that's all I needed. Is there a reference number for my call?
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Yes ma'am, you would actually just use my name that I gave you along with today's date.
[CUSTOMER][POSITIVE] OK, thank you so much.
[AGENT][POSITIVE] Well, you are very welcome and thank you for calling APL and I hope that you have a nice afternoon.
[CUSTOMER][NEUTRAL] OK bye bye.
[AGENT][NEUTRAL] Bye-bye.