AccountId: 011433970860
ContactId: 95e3ce89-9fed-4075-8755-729ce24f6fef
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 489829 ms
Total Talk Time (AGENT): 126596 ms
Total Talk Time (CUSTOMER): 172939 ms
Interruptions: 2
Overall Sentiment: AGENT=0.9, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/26/95e3ce89-9fed-4075-8755-729ce24f6fef_20250226T18:49_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from my GYN care. I have a claim that I don't, I haven't received anything back like an EOB from you guys. Can you see if you received it?
[AGENT][NEUTRAL] OK, do you have a phone number I can get in case we get disconnected I can call you back?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Sure, [PII].
[AGENT][NEUTRAL] And do you have a policy number?
[CUSTOMER][NEUTRAL] Yes, 01889829.
[AGENT][NEUTRAL] Thank you, [PII]. Hold on one moment, please.
[CUSTOMER][POSITIVE] OK, thanks.
[AGENT][NEUTRAL] And what's the patient's name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And her date of birth?
[CUSTOMER][NEUTRAL] And where did it go? [PII].
[AGENT][NEUTRAL] Thank you, [PII]. And you wanted to know if we received a certain claim?
[CUSTOMER][NEUTRAL] Yes, for you want the data service?
[AGENT][POSITIVE] Yes, ma'am. I can look that up for you.
[CUSTOMER][NEUTRAL] 8824.
[AGENT][POSITIVE] 8824. Thank you.
[CUSTOMER][NEUTRAL] Uh huh.
[AGENT][NEUTRAL] What was the charge?
[CUSTOMER][NEUTRAL] 175.
[AGENT][NEUTRAL] OK. Yes, ma'am. We did receive that. It was denied. Of visits are not covered under this policy.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] Got it, can you, um.
[CUSTOMER][NEUTRAL] Look up 2 more.
[AGENT][NEUTRAL] Is it on the same patient?
[CUSTOMER][NEUTRAL] Uh, let me see.
[CUSTOMER][NEUTRAL] No, they're two different ones. I don't know why I'm not getting the statements. Let me see.
[CUSTOMER][NEUTRAL] Like the EOBs from you guys.
[AGENT][NEUTRAL] Hold on just a second.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Pull up the claim and I can tell you what address it's going to.
[CUSTOMER][NEUTRAL] Because I have others on.
[CUSTOMER][NEUTRAL] There's a same patient but for a different procedure but nothing for that data service thank you [PII].
[AGENT][NEUTRAL] It went to [PII].
[CUSTOMER][NEUTRAL] Yeah, that would be electronically, right?
[AGENT][NEUTRAL] Uh, it would be a paper EO be mailed.
[CUSTOMER][NEUTRAL] Oh, maybe that maybe they didn't scan it in.
[CUSTOMER][NEUTRAL] I don't know, but I have, I have 2 more that it's probably not covered also.
[AGENT][NEUTRAL] You said it was on a different policy?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][POSITIVE] OK thanks.
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Like
[AGENT][NEUTRAL] OK, and what's the next one?
[CUSTOMER][NEUTRAL] Um, the ID number is 02304128.
[CUSTOMER][NEUTRAL] ML 8.
[AGENT][NEUTRAL] And the patient's name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the date of service.
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, they do have a new policy number for that data service is 0.
[CUSTOMER][NEUTRAL] Oh, let me write this down, uh huh.
[AGENT][NEUTRAL] Hold on just a second. Yeah, 11, OK, 0245.
[AGENT][NEUTRAL] 5574 and it was affected 1124.
[CUSTOMER][NEUTRAL] 1124. 0 wow. So 02455574?
[AGENT][NEUTRAL] So,
[AGENT][NEUTRAL] 4, uh-huh, let me check under that policy. Hold on one moment.
[CUSTOMER][NEUTRAL] OK. hm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] What was the charge?
[CUSTOMER][NEUTRAL] Uh, $600.
[AGENT][NEUTRAL] Yes, ma'am. Of visits are not covered under this policy.
[CUSTOMER][NEUTRAL] The same, OK.
[CUSTOMER][NEUTRAL] OK, and yeah, she gave me a [PII] card. OK, so I'll update that ID number and then the last one when you're ready.
[AGENT][NEUTRAL] Hold on just a second, let me put this one in and uh look at the other one. You're welcome.
[CUSTOMER][POSITIVE] OK, thank you so much.
[CUSTOMER][NEUTRAL] I'm assuming that goes to the same address, just different policy number?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, that one was 821 24, right?
[CUSTOMER][NEUTRAL] Uh, yes.
[AGENT][NEUTRAL] I can't read my own writing. I'm sorry about that.
[CUSTOMER][NEUTRAL] That's OK.
[CUSTOMER][NEUTRAL] I just do the same thing. Sometimes I look back and I'm like, what did I write?
[CUSTOMER][NEUTRAL] What was I even talking about?
[AGENT][NEUTRAL] OK, and what's the next one?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] The next one is um well hold on I'm still in hers. uh OK, [PII], let's see, she is 01647476 ML [PII].
[AGENT][NEUTRAL] And the patient's name?
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] And the date of service?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Excuse me.
[CUSTOMER][POSITIVE] Oh my gosh.
[AGENT][NEUTRAL] Is it for physical therapy?
[CUSTOMER][NEUTRAL] No, it was let's see, no.
[AGENT][NEUTRAL] That's not.
[AGENT][NEUTRAL] Uh, office visit.
[CUSTOMER][NEUTRAL] Office visit.
[AGENT][NEUTRAL] And the charge?
[CUSTOMER][NEUTRAL] 2, sorry, $300.
[AGENT][NEUTRAL] Yeah, it's the same thing, office visits are not covered.
[CUSTOMER][NEUTRAL] Office OK.
[CUSTOMER][POSITIVE] OK. Thank you so much for your help with these.
[AGENT][POSITIVE] You're welcome. Is there anything else I can help you with?
[CUSTOMER][NEUTRAL] That's it.
[AGENT][POSITIVE] Thank you, [PII], for calling APL. You have a good afternoon.
[CUSTOMER][POSITIVE] You as well take care bye bye.
[AGENT][POSITIVE] Thank you. Bye bye.