AccountId: 011433970860
ContactId: 930b6f36-3108-47ae-bd05-510c89110a65
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 385440 ms
Total Talk Time (AGENT): 119102 ms
Total Talk Time (CUSTOMER): 138439 ms
Interruptions: 4
Overall Sentiment: AGENT=0.9, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/28/930b6f36-3108-47ae-bd05-510c89110a65_20250428T19:50_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yeah, hi, this is [PII] calling from provider's office. I want to check the claim status.
[AGENT][NEUTRAL] Yes, I can help you with claim status today. What did you say your name was again?
[CUSTOMER][NEUTRAL] Yeah, my name is [PII] and my last name is [PII].
[AGENT][POSITIVE] Perfect. And then [PII], do you have the policy number?
[CUSTOMER][NEUTRAL] Yes, it's 01887307. M as in Mike, L as in Lima, number 8.
[AGENT][POSITIVE] OK, perfect. Thank you. And then what's a good callback number in case our call gets dropped?
[CUSTOMER][NEUTRAL] Uh, my callback number is [PII].
[AGENT][NEUTRAL] OK. And then the patient's first and last name and date of birth?
[CUSTOMER][NEUTRAL] It's uh [PII].
[CUSTOMER][NEUTRAL] It's uh [PII] and the date of birth is
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] It's just
[CUSTOMER][NEUTRAL] right.
[AGENT][NEUTRAL] OK, and do you have a data service and a charge amount?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, sure. The date of service is on [PII]. And the total charge amount is $3,045 even.
[AGENT][POSITIVE] OK, give me just one second. I'll look that claim up for you.
[CUSTOMER][NEUTRAL] Can.
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] They were.
[CUSTOMER][NEUTRAL] So.
[CUSTOMER][NEUTRAL] I do.
[AGENT][NEUTRAL] OK, so it looks like the received date for this claim is [PII].
[CUSTOMER][NEUTRAL] What.
[AGENT][NEUTRAL] The process date is [PII].
[CUSTOMER][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] It.
[CUSTOMER][NEUTRAL] In this way you'll get 3.
[CUSTOMER][NEUTRAL] Mhm. It has been paid?
[AGENT][NEUTRAL] Let's see what provider's office are you calling from?
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] It's uh Galloway Anesthesia Associates.
[AGENT][NEUTRAL] OK. Give me just one second.
[CUSTOMER][NEUTRAL] So.
[AGENT][NEUTRAL] OK, I'm sorry. The received date is actually [PII], and the processed date is, yes, sir.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And then the process date is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, and it looks like this claim was denied.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And the denial reason is.
[AGENT][NEUTRAL] It says these services were rendered after coverage was terminated, so this policy is no longer active.
[AGENT][NEUTRAL] When this claim was submitted.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So can you give me the effective date and termination date?
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] Yes, so it looks like the effective date is [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And the date paid to is [PII].
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] So it has been terminated on [PII], right?
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] And uh there is no other policy.
[CUSTOMER][NEUTRAL] Uh, and can you give me the claim number?
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So the claim number is 357.
[AGENT][NEUTRAL] 3255.
[CUSTOMER][NEUTRAL] And there is no other insurance for this number?
[AGENT][NEUTRAL] No, there is not.
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] So you just.
[CUSTOMER][NEUTRAL] Mm, OK. And can you spell your name?
[AGENT][NEUTRAL] Yes, of course. It's [PII]
[CUSTOMER][NEUTRAL] one.
[CUSTOMER][NEUTRAL] Mhm and call reference number?
[AGENT][NEUTRAL] Would be my first name, [PII], last initial [PII], and then today's date.
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][POSITIVE] Mhm. Yeah, fine. Thank you. Thank you so much. Have a good day. Bye-bye.
[AGENT][NEUTRAL] Yes
[AGENT][NEUTRAL] Yeah, is there anything else I can help you with?
[CUSTOMER][POSITIVE] Mhm, no, that's it. Thank you.
[AGENT][POSITIVE] OK, yes, thanks for calling APO have a.