AccountId: 011433970860
ContactId: a387e936-e11e-4e90-b585-ce503f9c87c1
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 469519 ms
Total Talk Time (AGENT): 176722 ms
Total Talk Time (CUSTOMER): 101755 ms
Interruptions: 1
Overall Sentiment: AGENT=0.7, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/10/a387e936-e11e-4e90-b585-ce503f9c87c1_20250210T15:29_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh hi, this is [PII]. I'm calling from provider's office checking on the claim status.
[AGENT][NEUTRAL] OK, [PII], you're needing claim status, is that correct?
[CUSTOMER][NEUTRAL] Right
[AGENT][POSITIVE] Yes ma'am, I can help you. [PII], what is your callback number?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you [PII] how many clients do you have to check status on?
[AGENT][NEUTRAL] Are they for the same member or different patients, same patient or different patients?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Different different patients.
[AGENT][NEUTRAL] OK, so [PII] you will use my name that I gave you along with today's date as your call reference number for each.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Also, any information that I provide for you today will be a verification of benefits and not a guarantee of payment.
[AGENT][NEUTRAL] And lastly is if we do have the claims on file and you need a copy of the explanation of benefits, you may print that by going to our portal and the website for our portal is [PII].
[CUSTOMER][NEUTRAL] Um
[AGENT][NEUTRAL] And what is your first patient's name and date of birth?
[CUSTOMER][NEUTRAL] Uh, [PII], [PII].
[AGENT][POSITIVE] Uh, I'm so sorry. Oh, I'm so sorry, [PII]. I got ahead of myself. What is that member's policy number first off, please?
[CUSTOMER][NEUTRAL] 1070427.
[AGENT][NEUTRAL] Did you say, I'm having trouble hearing you.
[AGENT][NEUTRAL] Repeat that number again.
[CUSTOMER][NEUTRAL] 107
[CUSTOMER][NEUTRAL] 0427.
[AGENT][POSITIVE] Thank you one moment.
[CUSTOMER][NEUTRAL] Let me
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, and what is your patient's name again, [PII], and their date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] And the data service and total bill amount, please.
[CUSTOMER][NEUTRAL] [PII] $46,688 even.
[AGENT][NEUTRAL] 36688, is that correct?
[CUSTOMER][NEUTRAL] 46, 6808.
[AGENT][NEUTRAL] 46688.
[CUSTOMER][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you one moment.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] OK, so I do see this claim was received on [PII].
[AGENT][NEUTRAL] It was processed and denied on [PII].
[AGENT][NEUTRAL] Claim number is 355-0927.
[AGENT][NEUTRAL] And the reason for the denial, [PII], is that we need a copy of the primary insurance company's explanation of benefits.
[CUSTOMER][NEUTRAL] Can I get your fax number?
[AGENT][NEUTRAL] [PII] attention claims.
[CUSTOMER][NEUTRAL] And is there any time spelling for submitting primary?
[AGENT][NEGATIVE] No, there is no.
[AGENT][NEGATIVE] There is not.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] OK, thank you. So, can we move on to the next one?
[AGENT][NEUTRAL] Sure, one moment.
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEGATIVE] Shut
[CUSTOMER][NEUTRAL] It
[AGENT][NEUTRAL] OK, and your next patient's policy number?
[CUSTOMER][NEUTRAL] 01960247 M as in Mike, L as in Lima, and 7.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] And your patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] And the data service and total bill amount for her place.
[CUSTOMER][NEUTRAL] [PII] 47,000, sorry, that's 45706106.
[AGENT][NEUTRAL] OK, 45706. Is that correct?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] And the day the service is 8-12-2024.
[CUSTOMER][POSITIVE] Correct.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, so this claim was received on [PII].
[AGENT][NEGATIVE] It was processed and denied on.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] The claim number is 3542076.
[AGENT][NEGATIVE] And it was denied for the same reason. We need the primary insurance company's explanation of benefits.
[CUSTOMER][POSITIVE] OK, thank you so much. That's all for now.
[AGENT][POSITIVE] Yes ma'am, you're welcome.
[AGENT][NEUTRAL] And is there anything else that I can help you with?
[CUSTOMER][POSITIVE] No, that's all. Thank you.
[AGENT][POSITIVE] Well, you're very welcome, [PII], and thank you again for calling [PII]. I hope you have a very nice day.
[CUSTOMER][POSITIVE] You too. Thank you. Bye-bye.