AccountId: 011433970860
ContactId: 950d903c-ee67-4ac6-bb15-786c24fa3b99
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 505959 ms
Total Talk Time (AGENT): 108864 ms
Total Talk Time (CUSTOMER): 149047 ms
Interruptions: 3
Overall Sentiment: AGENT=0.4, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/25/950d903c-ee67-4ac6-bb15-786c24fa3b99_20250425T19:24_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII], and I'm here to looking for a claim status.
[AGENT][NEUTRAL] OK. What did you say your name was again?
[CUSTOMER][NEUTRAL] It's [PII]
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And then do you have the policy number?
[CUSTOMER][NEUTRAL] It's 0230.
[CUSTOMER][NEUTRAL] It's 02300709.
[CUSTOMER][NEUTRAL] And now it's letter ML.
[CUSTOMER][NEUTRAL] M as in M as in Monday, L as in London, 7.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, and then what's a good callback number in case our call gets dropped?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. And then patient's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Patient name is [PII] and the date of birth is [PII].
[AGENT][POSITIVE] OK, perfect.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and then do you have a data service and a charge amount?
[CUSTOMER][NEUTRAL] Oh yes.
[CUSTOMER][NEUTRAL] It's uh [PII] and the charge amount is
[CUSTOMER][NEUTRAL] $2100.
[CUSTOMER][NEUTRAL] You
[AGENT][NEUTRAL] OK just one second.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, so it looks like for this claim, your received date was [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And the process date was [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] The claim was denied.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] Because
[AGENT][NEUTRAL] Hold on just one minute.
[AGENT][NEUTRAL] Let me go back.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, it looks like we're still waiting the EOB.
[CUSTOMER][NEUTRAL] OK. Uh, actually, we have already sent the UB also like previously one of the agent called you guys and
[CUSTOMER][NEUTRAL] We've got the same response from you guys. After that, the, like the agent already we submit the claim with the primary EOB.
[CUSTOMER][NEUTRAL] On [PII].
[AGENT][NEUTRAL] OK, just a minute.
[AGENT][NEUTRAL] Let me check our notes.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, just a second. Let me pull up their policy in another form and see if I see that we received the EOB, OK?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 150
[CUSTOMER][NEUTRAL] Hey
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Like
[AGENT][NEUTRAL] Can I ask you, did you guys send the claim through the mail or our fax number?
[CUSTOMER][NEUTRAL] Let me check that.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] It will send it to to mail on [PII], yes, it's and the
[AGENT][NEUTRAL] Male
[CUSTOMER][NEUTRAL] Mailing address is [PII].
[CUSTOMER][NEUTRAL] [PII], OK, [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Oh
[AGENT][POSITIVE] OK, that is correct.
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] What I.
[CUSTOMER][NEUTRAL] How about.
[AGENT][NEGATIVE] Yeah, for this claim, it just says that it's denied.
[AGENT][NEUTRAL] Because of the EOB.
[AGENT][NEUTRAL] Our claims department still could be reviewing it.
[AGENT][NEUTRAL] I cannot see on my end.
[CUSTOMER][NEUTRAL] OK, so can you please confirm me like uh what is the time frame to uh for the claim information or?
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] So there is no filing limit to submit a claim. Um, I am unsure of how long it takes the claims department to submit the EOB.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And or sorry to review it.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, OK, no issue. Let me just mention that in my records and move to the next level. Can you please give me the call reference number?
[AGENT][NEUTRAL] Yes, of course. It's my first name, [PII]
[AGENT][NEUTRAL] [PII]
[AGENT][POSITIVE] And it would be today's date, yeah. You're welcome.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] OK, that's all. Have a good day ahead.
[AGENT][NEUTRAL] OK, well, thanks for calling AP.