AccountId: 011433970860
ContactId: a7535709-4520-4318-bf22-26b48caa53dc
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 505119 ms
Total Talk Time (AGENT): 105755 ms
Total Talk Time (CUSTOMER): 143834 ms
Interruptions: 2
Overall Sentiment: AGENT=1.2, CUSTOMER=-0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/20/a7535709-4520-4318-bf22-26b48caa53dc_20250220T16:44_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII]. I'm calling for a provider, [PII]. And please note this call will be recorded and monitored for quality and training purposes. And I'm here to check on a claim status.
[AGENT][NEUTRAL] OK [PII], I can help you with the claim status. Can I please get your callback number?
[CUSTOMER][NEUTRAL] Yeah, sure. My callback number will be [PII] and it's a direct line.
[AGENT][NEUTRAL] Thank you sir and then what is the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Yeah, the patient name is uh [PII].
[CUSTOMER][NEUTRAL] And then the patient date of birth will be [PII].
[CUSTOMER][NEUTRAL] And then the policy number will be 023.
[CUSTOMER][NEUTRAL] 299
[CUSTOMER][NEUTRAL] 07.
[AGENT][NEUTRAL] OK, let me look up that policy real quick.
[CUSTOMER][NEUTRAL] Yeah, sure. Take your time. By the way, your name is [PII], right?
[AGENT][POSITIVE] Thank you, sir.
[AGENT][POSITIVE] Yes, that's correct.
[AGENT][NEUTRAL] OK, [PII], what is the date of service?
[CUSTOMER][POSITIVE] Yeah, take your time, [PII].
[CUSTOMER][NEUTRAL] Yeah, the date of service will be [PII].
[AGENT][NEUTRAL] And the charge amount?
[CUSTOMER][NEUTRAL] Yeah, the charge amount will be.
[CUSTOMER][NEUTRAL] $1,118.21.
[AGENT][NEUTRAL] Thank you. And what is the name of the facility you're calling for, [PII]?
[CUSTOMER][NEUTRAL] Yeah, I'm just, uh, the first name will be.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Uh EMP of Campaign County LDD.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, I'm gonna put you on a brief hold while I look up this claim for you and I'll be right back.
[CUSTOMER][POSITIVE] Yes, sir. Take your time.
[AGENT][POSITIVE] Thank you, sir.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK [PII], this is [PII] back with you again.
[AGENT][NEUTRAL] I did find the claim.
[AGENT][NEUTRAL] The claim number is 346.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] It
[AGENT][NEUTRAL] 351 3.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Just.
[AGENT][NEUTRAL] The claim was received on [PII] and was processed on [PII].
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And the claim was denied because we're waiting on eligibility from the employer.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] For this this week.
[AGENT][NEUTRAL] Of service.
[AGENT][NEUTRAL] Once we receive eligibility from the employer, we can reprocess the claim.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, give me a minute, uh, sorry, let me check my information whether the patient is eligible or not. Give me a minute.
[AGENT][NEUTRAL] Yes sir.
[CUSTOMER][NEUTRAL] Uh, thanks for your patience. Uh, uh, you need the COB information from the patient, right?
[AGENT][NEUTRAL] We need eligibility from the employer because as of right now the patient was not eligible on that data service.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, give me a minute.
[CUSTOMER][NEUTRAL] Uh, may I know the patient, uh, effective date and the date, uh, sorry?
[AGENT][NEUTRAL] Yes, the effective date is [PII]. The termination date is [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh, may I know after the termination, uh, is there any need?
[CUSTOMER][NEUTRAL] The policy code renewed after the termination?
[AGENT][NEUTRAL] Yes, the policy was terminated on [PII], and there are no active policies after that date.
[CUSTOMER][NEUTRAL] After that, no active policies, right? Till it not a renewed, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Yeah. And uh uh may I know is there any other insurance uh information of the patient is there?
[AGENT][NEUTRAL] No, we don't have any other information.
[CUSTOMER][NEUTRAL] OK, sure. And um as you stated, the claim number was 346.
[CUSTOMER][NEUTRAL] 351-3, right?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, thanks for your information, [PII]. Uh, may I know the call reference number, [PII]?
[AGENT][NEUTRAL] Yes, you can use my name and today's date.
[CUSTOMER][POSITIVE] Yeah, sure, [PII], and thanks for your wonderful lessons, [PII]. Have a great day. Bye-bye.
[AGENT][POSITIVE] You too [PII] you have a blessed day thanks.