AccountId: 011433970860
ContactId: 89c3687b-bfcf-486c-bcdd-c30d31f8309a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 361440 ms
Total Talk Time (AGENT): 135133 ms
Total Talk Time (CUSTOMER): 106796 ms
Interruptions: 1
Overall Sentiment: AGENT=0.7, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/03/89c3687b-bfcf-486c-bcdd-c30d31f8309a_20250203T15:45_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Claims.
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII]. How are you doing today?
[AGENT][POSITIVE] I'm doing well how are you?
[CUSTOMER][POSITIVE] Yeah, I'm doing good, thanks for asking me.
[AGENT][NEUTRAL] I'm sorry, you said your name was [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, um, [PII], can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure, it's [PII].
[AGENT][POSITIVE] OK thank you and what can we help you with today?
[CUSTOMER][NEUTRAL] Like
[AGENT][NEUTRAL] Needing to check on a claim?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, do you have the policy number?
[CUSTOMER][NEUTRAL] Sure. The policy number is 024497773.
[AGENT][NEUTRAL] Thank you. And what was the name and date of birth for the insured?
[CUSTOMER][NEUTRAL] Mhm. Uh, it was [PII].
[AGENT][NEUTRAL] Do you have the date of birth?
[CUSTOMER][NEUTRAL] Sure, the date of birth was
[CUSTOMER][NEUTRAL] Uh, it's [PII].
[AGENT][NEUTRAL] OK, thank you for verifying that [PII]. uh, what was the date of service for this claim?
[CUSTOMER][NEUTRAL] Data service was
[CUSTOMER][NEUTRAL] Uh, it's [PII].
[AGENT][NEUTRAL] OK, uh, the bill amount please.
[CUSTOMER][NEUTRAL] 2:16 even.
[AGENT][NEUTRAL] I'm sorry, that was 260 even?
[CUSTOMER][NEUTRAL] 16 1 16
[CUSTOMER][NEUTRAL] Like the
[AGENT][POSITIVE] One sec, OK, thank you.
[AGENT][NEUTRAL] And uh what was the name of the provider's office this was with?
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] The provider's office please the name or if you have the tax ID?
[CUSTOMER][NEUTRAL] Uh, tax ID [PII].
[AGENT][NEUTRAL] OK thank you one moment.
[AGENT][NEUTRAL] OK, so I did find this claim. Allen, uh, looks like we are missing a key of the primary EOB.
[CUSTOMER][NEUTRAL] She was primary hobby.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] I do have
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Uh, can you check on that one I need.
[CUSTOMER][NEUTRAL] OK. Uh, do you have a claim number?
[AGENT][NEUTRAL] Yes, that is 3553775.
[CUSTOMER][NEUTRAL] 1 2nd. 1 2nd, 3.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 35
[AGENT][NEUTRAL] Yes, 3553.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] 73
[AGENT][NEUTRAL] No, 3553.
[CUSTOMER][NEUTRAL] 53
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 775.
[CUSTOMER][NEUTRAL] 775.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK. When did you receive this plan?
[AGENT][NEUTRAL] This one was received in [PII].
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] And it was also processed to [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, the next payment will be OK.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Uh, I do have one more data service to check.
[AGENT][NEUTRAL] Is this for the same member?
[CUSTOMER][NEUTRAL] So,
[CUSTOMER][NEUTRAL] Yes, same number.
[AGENT][NEUTRAL] OK, what was that day of service?
[CUSTOMER][NEUTRAL] Again, it's [PII] with the charge of 407 even.
[AGENT][NEUTRAL] 4407.
[CUSTOMER][NEUTRAL] Yes, yes.
[AGENT][NEUTRAL] OK um was this with the same provider?
[CUSTOMER][NEUTRAL] Uh, no, that is, uh.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] No, it's a different, uh.
[AGENT][NEUTRAL] Or the same tax ID?
[CUSTOMER][NEUTRAL] Yes, same tax ID.
[AGENT][POSITIVE] It is OK.
[CUSTOMER][NEUTRAL] Hello
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So for this one, [PII], um, the top item, uh, we office visits are not covered under this policy, so that's procedure code 99214. We were unable to pay a benefit because office visits are not covered. The other procedure codes, uh, we are missing that primary EOB.
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] OK, again it's missing for you.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK. When did you receive this time or it?
[AGENT][NEUTRAL] Uh yes, we received this 1 [PII], and it was processed [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, what's the claim number?
[AGENT][NEUTRAL] It is 35.
[AGENT][NEUTRAL] 53.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 769.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Can I get your name and the contact number?
[AGENT][NEUTRAL] Reference number would just be my first name, last initial and today's date. Uh, so my name is spelled [PII] was there anything else I could help you with, [PII]?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Thank you. Have a great day for you.
[AGENT][POSITIVE] Yeah, thanks for calling APO you too bye bye.