AccountId: 011433970860
ContactId: 8e4903e9-a62c-49a1-85f3-9e87992de9d3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 224660 ms
Total Talk Time (AGENT): 72562 ms
Total Talk Time (CUSTOMER): 86502 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/20/8e4903e9-a62c-49a1-85f3-9e87992de9d3_20250620T19:44_UTC.wav
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[AGENT][NEUTRAL] And thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey, hi, this is [PII] calling you from provider's office to check on the claim status.
[AGENT][NEUTRAL] 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] Sure. It's [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII] and extension [PII].
[AGENT][POSITIVE] Thank
[AGENT][NEUTRAL] OK, got it. And could I get the policy number, please?
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Sure. It's 022.
[CUSTOMER][NEUTRAL] 053
[CUSTOMER][NEUTRAL] 74 M as in Mike, L as in Lima.
[CUSTOMER][NEUTRAL] 8.
[AGENT][NEUTRAL] OK. Please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] And the date of birth is [PII].
[AGENT][NEUTRAL] OK. Thank you. Now, I need the date of service and bill charges on the claim, please.
[CUSTOMER][NEUTRAL] It's for [PII].
[CUSTOMER][NEUTRAL] And the bill amount $542 even.
[AGENT][NEUTRAL] OK. Yes, sir. We received that claim on [PII].
[AGENT][NEUTRAL] The claim processed on [PII].
[AGENT][NEUTRAL] The claim number is 361-3126.
[AGENT][NEUTRAL] And this claim denied because office visits are not covered under the member's policy.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm. And I will repeat the claim number, 361-3126, correct?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] Yeah, ma'am. And can I get a copy of the EOB of the denied claim?
[AGENT][NEUTRAL] Yes, what I can fax it to you. What's your fax number?
[CUSTOMER][NEUTRAL] Sure, it's [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK. So that's attention added.
[CUSTOMER][NEUTRAL] Um, can we bill this to a patient?
[AGENT][POSITIVE] Yes, you can.
[CUSTOMER][POSITIVE] Yeah, yes, ma'am. Correct.
[AGENT][NEUTRAL] OK, and the fax number is [PII]?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Yes, ma'am. Correct.
[AGENT][NEUTRAL] OK. You should receive it in about 10 minutes. Is there anything else that I can assist you with?
[CUSTOMER][NEUTRAL] Mhm. That's it for the day, ma'am.
[CUSTOMER][NEUTRAL] And before we call, can we have the call reference number?
[AGENT][NEUTRAL] Yes, for the reference number, you can use my name in today's date.
[CUSTOMER][NEUTRAL] Would you please spell your name, ma'am?
[AGENT][NEUTRAL] Um, it's [PII].
[CUSTOMER][POSITIVE] Mm, I got that, ma'am. And that's all for today and you have a happy weekend ahead.
[AGENT][NEUTRAL] You do the same, [PII]. Thank you for calling APL. Mm bye.
[CUSTOMER][POSITIVE] Mm mhm. Bye for now. Have a good day.