AccountId: 011433970860
ContactId: 94ebc751-651f-4d16-9854-1332f0cae4fe
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 496679 ms
Total Talk Time (AGENT): 110267 ms
Total Talk Time (CUSTOMER): 82179 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=-0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/26/94ebc751-651f-4d16-9854-1332f0cae4fe_20250326T16:52_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Mm hello. This is [PII] calling from the Louisiana Healthcare Associate to verify the claim status. And could you please spell out your name?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, it's [PII]
[CUSTOMER][NEUTRAL] Sure. OK, got it.
[AGENT][POSITIVE] OK, thank you and [PII], I can help you with that can you please give me your call back number?
[CUSTOMER][NEUTRAL] [PII] is a direct line?
[AGENT][NEUTRAL] Thank you, sir. And what's the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Member's ID number would be.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 01739515
[CUSTOMER][NEUTRAL] Patient name would be [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] OK, let me pull up that policy real quick.
[CUSTOMER][NEUTRAL] 23.
[CUSTOMER][NEUTRAL] $40.
[AGENT][NEUTRAL] OK, and then what is the date of service and the charge amount of the claim?
[CUSTOMER][NEUTRAL] D of service would be [PII], with the total charge amount of $140.
[AGENT][NEUTRAL] OK, and what's the charges after the primary insurance paid?
[CUSTOMER][NEUTRAL] $55.22.
[AGENT][NEUTRAL] OK, and you said that the name of your facility was Lucia?
[CUSTOMER][NEUTRAL] Louisiana Healthcare Associate.
[AGENT][NEUTRAL] Healthcare.
[AGENT][NEUTRAL] OK, I'm gonna put you on a brief hold while I look up this claim for us and I'll be right back.
[CUSTOMER][POSITIVE] Mhm. Sure. Take your time.
[AGENT][POSITIVE] Thank you, sir.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Thank you [PII] for holding for me so I have the claim pulled up, but first let me give you the correct policy number.
[AGENT][NEUTRAL] The active policy number is 235.
[AGENT][NEUTRAL] 7692.
[AGENT][NEUTRAL] The claim number is 354-449-99.
[AGENT][NEUTRAL] And the claim was denied because office visits are not covered under the patient's policy.
[CUSTOMER][NEUTRAL] And could you please uh provide the denial date?
[AGENT][NEUTRAL] Yes, let me give that to you.
[AGENT][NEUTRAL] We received the claim on [PII].
[AGENT][NEUTRAL] And process the claim on [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And also, could you please uh fax the EOB?
[AGENT][NEUTRAL] Yes, sir. Can I get your fax number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] 922 was the last four digits?
[CUSTOMER][NEUTRAL] No, [PII].
[AGENT][NEUTRAL] OK, I'm gonna put you on a quick hold while I get that fax ready for you and I'll be right back.
[CUSTOMER][NEUTRAL] Mhm. Sure.
[AGENT][POSITIVE] Thank you, sir.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you [PII] for holding for me. I've got that fax on its way to you now, sir.
[CUSTOMER][POSITIVE] Mhm. And uh thank you so much uh for providing the information. Sorry and
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And may I know the call reference number?
[AGENT][NEUTRAL] Yes, you can use my name [PII] and today's date.
[CUSTOMER][POSITIVE] And thank you so much, [PII], for providing the assistance. Have a great day.
[AGENT][NEUTRAL] You too, [PII], is there anything else I can help you with before we go?
[CUSTOMER][NEUTRAL] Uh, no, thank you for asking.
[AGENT][POSITIVE] You're welcome you have a wonderful day and thank you for calling APA.
[CUSTOMER][POSITIVE] Have a great day. Bye.
[AGENT][NEUTRAL] Bye bye, sir.