AccountId: 011433970860
ContactId: 8c21bfa5-215a-47c3-af4b-9fad1824de49
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 238649 ms
Total Talk Time (AGENT): 102588 ms
Total Talk Time (CUSTOMER): 74688 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/09/8c21bfa5-215a-47c3-af4b-9fad1824de49_20250509T12:46_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Um, hello, my name is [PII]. I'm calling on behalf of a medical provider for claim status.
[AGENT][NEUTRAL] I'm sure, [PII], I can assist you with claim status. Um, first, could I get a good callback number just in case we're disconnected?
[CUSTOMER][NEUTRAL] Um, yes, that would be [PII] direct line.
[AGENT][NEUTRAL] Thank you. Now, I need the policy number, please.
[CUSTOMER][NEUTRAL] Um, yes, the one that we have is 01984262 M for Mike, L for Lima, 7.
[AGENT][NEUTRAL] Thank you. Now, please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you. Now I need the date of service and bill charges on the claim.
[CUSTOMER][NEUTRAL] It was [PII].
[CUSTOMER][NEUTRAL] And the total charges should be $1,002.
[AGENT][NEUTRAL] OK, one moment, please.
[AGENT][NEUTRAL] OK. Thanks for your patience. Yes, I'm showing that we received this claim on [PII].
[AGENT][NEUTRAL] The claim processed on [PII].
[AGENT][NEUTRAL] The claim number is 356-4105.
[AGENT][NEUTRAL] And I'm showing that this claim denied because actually, well just let me advise you that verification of coverage does not guarantee payment of claims. I'm showing the effective date on this policy was [PII] and the policy expired on [PII]. So that's why the claim denied the policy had expired um before the date of service. Mhm.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Oh, I see. OK, um, we actually didn't know that. Thank you for that.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK. And is there any
[CUSTOMER][NEUTRAL] And just in case, I
[CUSTOMER][NEUTRAL] Um, yeah, sorry, uh, just in case, are you able to send over a copy of that denial EOB to us?
[AGENT][NEUTRAL] Um, yes, I can fax it to you. What's your fax number, please?
[CUSTOMER][NEUTRAL] Um, yes, that would be [PII].
[AGENT][NEUTRAL] OK, and to whose attention?
[CUSTOMER][NEUTRAL] Uh, you can add my name, [PII].
[AGENT][NEUTRAL] OK, so that's attention, [PII] [PII].
[CUSTOMER][POSITIVE] Yes, that's right.
[AGENT][NEUTRAL] OK. You should receive it in about 10 minutes. I just sent it. Um, is there anything else I can assist you with?
[CUSTOMER][NEUTRAL] Um, no, it's only a reference number if you have one.
[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] Last initial is [PII], and today's date.
[CUSTOMER][POSITIVE] OK, great. Thank you.
[AGENT][POSITIVE] OK. Thank you, [PII], for calling APL. You have a great rest of your day. Mm bye.
[CUSTOMER][POSITIVE] Thank you. You too. Bye-bye.
[AGENT][NEUTRAL] Bye.