AccountId: 011433970860
ContactId: 9a69acf2-ab4b-4ba6-85c2-78f87171362d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 549630 ms
Total Talk Time (AGENT): 126050 ms
Total Talk Time (CUSTOMER): 163386 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/13/9a69acf2-ab4b-4ba6-85c2-78f87171362d_20250613T16:24_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[AGENT][POSITIVE] Good morning.
[CUSTOMER][NEUTRAL] Hello, good morning. This is [PII] calling from provider's office to check up on a claim status. Also, this call is being recorded for quality and training purposes. Are you OK with that?
[AGENT][NEUTRAL] That's fine, and I can verify claim status for you and you say your name is [PII]?
[CUSTOMER][POSITIVE] Yeah, that's right. Oh, actually I didn't catch your name, sorry for that.
[AGENT][NEUTRAL] It's spell it for me.
[AGENT][NEUTRAL] Sure, it's [PII], last initial [PII]
[CUSTOMER][NEUTRAL] Can you help me with that?
[AGENT][NEUTRAL] And spell your name for me, please.
[CUSTOMER][NEUTRAL] Yeah, it's [PII]. It's [PII], last name initial [PII].
[AGENT][NEUTRAL] OK, and what is the policy number, please?
[CUSTOMER][NEUTRAL] It's just give me a moment.
[CUSTOMER][NEUTRAL] The policy number would be 249-7635.
[AGENT][NEUTRAL] OK, thank you. And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] Yeah, it's [PII].
[AGENT][NEUTRAL] OK, thank you and the patient's name, date of birth?
[CUSTOMER][NEUTRAL] Uh, yeah, the member's name is [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] OK, and what was the date of service and the amount of the charge?
[CUSTOMER][NEUTRAL] Um, yeah, it's [PII].
[CUSTOMER][NEUTRAL] Uh, with the total charge $100 even.
[AGENT][NEUTRAL] And do you have the balance after primary?
[CUSTOMER][NEUTRAL] It's $32.85.
[AGENT][NEUTRAL] OK, one moment, please.
[AGENT][NEUTRAL] OK and the name of the provider's office?
[CUSTOMER][NEUTRAL] It's Pembroke Pink Imaging LLC.
[AGENT][NEUTRAL] OK, I'm showing the claim process is needing primary insurance explanation of benefits.
[CUSTOMER][NEUTRAL] Uh, when did you receive the claim?
[AGENT][NEUTRAL] Uh, the claim was received on [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Uh, do you also have a denial date or process date?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, just give me a moment.
[CUSTOMER][NEUTRAL] I for primary explanation of benefit.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh yeah, can you help me with the claim number?
[AGENT][NEUTRAL] Uh, sure, 35, I'm sorry, uh, claim number is 3601956.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Can you also help me with the call reference number for this member and I do have some more claims with me like the.
[CUSTOMER][NEGATIVE] One another claim with me for different member.
[AGENT][NEUTRAL] You said one other claim?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, um.
[AGENT][NEUTRAL] A reference number you may use my name and today's date and before you give any other information, give me one moment please.
[CUSTOMER][POSITIVE] Sure, take your time.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 21.
[AGENT][NEUTRAL] I apologize, I have to.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Type in a note.
[CUSTOMER][NEUTRAL] That's fine, take your time.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] Thank you
[AGENT][NEUTRAL] OK, and what is the next policy number?
[CUSTOMER][NEUTRAL] Uh yeah, it would be 02.
[CUSTOMER][NEUTRAL] 5079.
[CUSTOMER][NEUTRAL] 24 M as in Mike L as in Lima 8.
[AGENT][NEUTRAL] OK, patient's name, date of birth?
[CUSTOMER][NEUTRAL] Member's name is, it's [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] And verify that patient's name again?
[CUSTOMER][NEUTRAL] Um, can I spell it to you?
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Yeah, the last name is [PII]. And the first name is [PII].
[AGENT][NEUTRAL] OK. And do you see um a middle initial?
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] Do you see any middle initial for the patient?
[CUSTOMER][NEGATIVE] Mm no.
[AGENT][NEUTRAL] Of their name? OK.
[AGENT][NEUTRAL] OK, because I just see a different, uh, name in the system. OK, and what was the date of service and amount of the charge?
[CUSTOMER][NEUTRAL] Um, just a moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, yeah, the date of service is [PII]. Total charge $500 even.
[AGENT][NEUTRAL] OK, and the balance after primary?
[CUSTOMER][NEUTRAL] It's $150 even.
[AGENT][NEUTRAL] OK, and the name of the provider's office?
[CUSTOMER][NEUTRAL] It's diagnostic Center for Women LLC.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] Uh, we will need the primary EOB for this claim as well.
[CUSTOMER][NEUTRAL] well
[CUSTOMER][NEUTRAL] OK. When did you receive the claim?
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] Uh, claim received [PII], processed on [PII].
[CUSTOMER][NEUTRAL] [PII]. Can you also help me with the claim number?
[AGENT][NEUTRAL] 360-1942
[CUSTOMER][POSITIVE] OK, thank you so much.
[AGENT][NEUTRAL] OK. Uh, is there anything else I can assist you with today?
[CUSTOMER][POSITIVE] Uh, no, thank you so much. That's it for the day. Hope you have a wonderful day.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] You too, thanks for calling APL. Have a great day.
[CUSTOMER][POSITIVE] Bye bye take care.
[AGENT][NEUTRAL] Bye.
[CUSTOMER][NEUTRAL] I