AccountId: 011433970860
ContactId: 94b4677a-190d-4ad4-9a31-b63a2eb0aa4e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 298600 ms
Total Talk Time (AGENT): 109572 ms
Total Talk Time (CUSTOMER): 122311 ms
Interruptions: 2
Overall Sentiment: AGENT=0.7, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/14/94b4677a-190d-4ad4-9a31-b63a2eb0aa4e_20250514T17:20_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. This is [PII] calling from MESC physicians to check on a claim status.
[AGENT][POSITIVE] OK, well, I'll be more than happy to help you with the claim status today, [PII]. May I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Callback number is [PII] direct line.
[AGENT][NEUTRAL] Thank you for that and the member's policy number?
[CUSTOMER][NEUTRAL] Policy number is 025.
[CUSTOMER][NEUTRAL] 60355
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Member's name is [PII] and date of birth, [PII].
[AGENT][NEUTRAL] And that's policy number 256-735-5.
[CUSTOMER][NEUTRAL] No, policy number is 025.
[CUSTOMER][NEUTRAL] 60355.
[AGENT][NEUTRAL] 0. OK, sorry about that. Hold on one moment.
[AGENT][NEUTRAL] All right, here you go. Thank you for verifying um the member's policy and all the information provided is a verification of benefits, not a guarantee of payment. And just since the policy just popped up, can you repeat the date of birth for me, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you for that. And may I have the date of service and the total bill?
[CUSTOMER][NEUTRAL] Data services, [PII] for the bill amount of $315 even.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Hold on one moment.
[AGENT][NEUTRAL] So for [PII], I'm not showing a claim on file for [PII], but let me see, no, this is the only policy. You said [PII], correct, not [PII]?
[CUSTOMER][NEUTRAL] Correct, [PII] for the bill amount of $315 even 315.
[AGENT][NEUTRAL] Right, I understand. Um, so there's no.
[CUSTOMER][NEUTRAL] You want the claim number?
[AGENT][NEUTRAL] You have a claim number? Sure. What's the claim number?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Claim number is 358.
[CUSTOMER][NEUTRAL] 4152.
[AGENT][NEUTRAL] Hold on one moment.
[CUSTOMER][NEUTRAL] Hello.
[AGENT][NEUTRAL] OK, this has a date of service of [PII]. I just confirmed [PII] and you said that was correct, so it's the wrong date. Hold on one moment.
[CUSTOMER][NEUTRAL] You hear me?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Yeah yeah get my.
[AGENT][NEUTRAL] OK, so the claim was received on [PII]?
[AGENT][NEUTRAL] And on [PII], the claim was denied requesting an explanation of benefits from primary insurance.
[CUSTOMER][POSITIVE] that's good.
[CUSTOMER][NEUTRAL] You got it. Can I have the mailing address to reach with the EB.
[AGENT][NEUTRAL] Sure, it's [PII].
[CUSTOMER][NEUTRAL] I yeah.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] Zip code is [PII].
[CUSTOMER][NEUTRAL] Can I have the annual limit for Summit AB?
[AGENT][NEUTRAL] Um, there's no timely filing for additional information. As soon as we receive it, we'll continue processing.
[CUSTOMER][NEUTRAL] Mm, got it.
[CUSTOMER][NEUTRAL] Can I have the payer ID?
[AGENT][NEUTRAL] I pay ID is 60801.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Got it. Can I have the reference number for this call?
[AGENT][NEUTRAL] Sure, there's no call reference number. You can use my name in today's date, which is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Thank you so much for your patiencely assisting me, [PII]. Have a great day. Stay safe. Take care. Bye-bye.
[AGENT][POSITIVE] Bye bye. Thanks for calling APL.
[CUSTOMER][NEUTRAL] you know
[CUSTOMER][NEUTRAL] You