AccountId: 011433970860
ContactId: 9aae1bee-5244-4386-9e78-654cdf277416
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 270260 ms
Total Talk Time (AGENT): 104001 ms
Total Talk Time (CUSTOMER): 80389 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/24/9aae1bee-5244-4386-9e78-654cdf277416_20250124T16:58_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] from provider office to check the claim status.
[AGENT][NEUTRAL] OK, I could check on a claim for you. I'm sorry, what did you say your name was?
[CUSTOMER][NEUTRAL] It's [PII]
[AGENT][NEUTRAL] That was [PII]
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[AGENT][POSITIVE] OK thank you and then can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. Do you have the policy number?
[CUSTOMER][NEUTRAL] It's
[CUSTOMER][NEUTRAL] Yes, it's uh 01914394. M as in Mike, L as in Lima, 7 as in number.
[AGENT][NEUTRAL] Alright, thank you. And what was the name and date of birth for the insured?
[CUSTOMER][NEUTRAL] I first name is [PII] and last name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Alright, thank you for verifying that uh what was the date of service for this claim?
[CUSTOMER][NEUTRAL] Data services [PII] with bill amount $570 even.
[AGENT][NEUTRAL] 70. OK, thank you one moment please.
[CUSTOMER][NEUTRAL] So, actually, I have a specific question for this claim.
[AGENT][NEUTRAL] OK, give me just a moment let me find that for you. Did you have the claim number?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, could you give that to me?
[CUSTOMER][NEUTRAL] Yeah, just been.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] The claim number is 352-419-2.
[AGENT][POSITIVE] Alright thank you one moment please.
[AGENT][NEUTRAL] And this was with Holy Cross Medical Group?
[CUSTOMER][POSITIVE] Yes, that's correct.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Did you just need clarification on the denial?
[CUSTOMER][NEUTRAL] Actually, the Supreme Court denied as duplicate and there is no version of claim status that
[AGENT][NEUTRAL] Oh yes, I see that.
[AGENT][NEUTRAL] OK, OK, give me just a moment. I'll find the original.
[CUSTOMER][NEUTRAL] Yeah and we have sent this.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, bear with me just a moment. Looks like we've received it several times.
[AGENT][NEUTRAL] OK, so I did find that original claim but just a moment. I can get you that claim number, um, so we were unable to pay a benefit as office visits are not covered under this policy.
[CUSTOMER][NEUTRAL] And that claim number is 352-4192, right?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] No, that is not the original claim that was a duplicate that we received. I do have that original claim number.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The original claim number, yes, it is 347-528-3.
[CUSTOMER][NEUTRAL] Can I have that number?
[CUSTOMER][POSITIVE] Thank you so much. Uh, I have that you be but uh
[CUSTOMER][NEUTRAL] For the claim number, you will be billed amount is different. Uh, the bill amount is $629.
[AGENT][NEGATIVE] Yes, there were a few different items on there. The duplicate, the EOB, excuse me, the claim number that you gave me, it was the same item for the same date of service though that 570, that was the office visit and that was what we were unable to pay.
[CUSTOMER][NEUTRAL] Sure. And uh can you spell your name for me?
[AGENT][NEUTRAL] Yeah, it's [PII].
[CUSTOMER][NEUTRAL] And your last initial?
[AGENT][NEUTRAL] A
[CUSTOMER][NEUTRAL] Also, can I get the call reference number?
[AGENT][NEUTRAL] Reference number would just be my first name, last initial and today's date. Uh, was there anything else I could help you with?
[CUSTOMER][POSITIVE] Nothing else. Thank you so much for assisting. Have a great day and stay safe.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Yeah, thanks for calling APL you too bye bye.