AccountId: 011433970860
ContactId: 9df692c9-d128-4c73-9f4a-d37a91d73b48
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 188880 ms
Total Talk Time (AGENT): 74011 ms
Total Talk Time (CUSTOMER): 54780 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/24/9df692c9-d128-4c73-9f4a-d37a91d73b48_20250624T15:29_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling you from providers office upon checking general claim status.
[AGENT][NEUTRAL] OK, I can look you claim status, [PII]. Do you have a good callback number?
[CUSTOMER][NEUTRAL] Yeah, it's [PII].
[AGENT][NEUTRAL] The policy number for the patient?
[CUSTOMER][NEUTRAL] You mean member ID?
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] 026 058
[CUSTOMER][NEUTRAL] 08.
[AGENT][NEUTRAL] And patient name and date of birth?
[CUSTOMER][NEUTRAL] It's uh [PII]. Date of birth [PII].
[AGENT][NEUTRAL] And the date of service and bill charges?
[CUSTOMER][NEUTRAL] At [PII] and the total bill amount $1,553. 45 cents.
[AGENT][NEUTRAL] OK, looks like the claim was received 527-25.
[AGENT][NEUTRAL] And it was processed 63-2025.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And let's see.
[AGENT][NEUTRAL] Uh, the explanation of benefits did not list the amounts applied to deductible co-pay or co-insurance, so we need a more detailed explanation.
[CUSTOMER][NEUTRAL] What is it
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, you mean, you need primary OB, correct?
[AGENT][NEUTRAL] We need the primary we received it, but it didn't show any detail. So we need a primary EOB that shows the amounts applied to deductible, co-pay, or co-insurance.
[CUSTOMER][NEUTRAL] Can you provide me the claim number?
[AGENT][NEUTRAL] Claim number 3608745.
[CUSTOMER][NEUTRAL] Can you start over?
[AGENT][NEUTRAL] 3608745.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 3608745 is the claim number and you need primary OB correct?
[AGENT][NEUTRAL] Yes, we need a more detailed primary EOB, yes.
[CUSTOMER][NEUTRAL] 1 2nd.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Can you provide your mailing address?
[AGENT][NEUTRAL] Mailing address is [PII].
[AGENT][NEUTRAL] It's [PII] City, [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] What is the timely selling limit?
[AGENT][NEGATIVE] There's no timely filing limit.
[CUSTOMER][NEUTRAL] OK. Can you go for the cold difference?
[AGENT][NEUTRAL] All reference is my name is [PII], first initial and last name, [PII], and today's date.
[CUSTOMER][POSITIVE] Thank you so much, [PII], for assisting me. You have a wonderful day. Bye-bye.
[AGENT][POSITIVE] Thank you for calling APL. You as well. Bye bye.