AccountId: 011433970860
ContactId: aef047b0-0669-4570-9e93-45b21cc63898
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 356290 ms
Total Talk Time (AGENT): 69766 ms
Total Talk Time (CUSTOMER): 93963 ms
Interruptions: 0
Overall Sentiment: AGENT=0, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/20/aef047b0-0669-4570-9e93-45b21cc63898_20250620T21:47_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes, my first name is [PII]. My last name is [PII] calling you from the provider's office looking for claim status.
[AGENT][NEUTRAL] OK, [PII], I can help you with claim status. Do you have a good callback number?
[CUSTOMER][NEUTRAL] The callback number is [PII]. And could you please repeat again your name, please?
[AGENT][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And do you have the policy number for the patient?
[CUSTOMER][NEUTRAL] Uh, yes, the patient's uh first name is, I mean.
[CUSTOMER][NEUTRAL] Just hold on, uh, the patient ID is.
[CUSTOMER][NEUTRAL] 021-79837.
[AGENT][NEUTRAL] And patient name and date of birth?
[CUSTOMER][NEUTRAL] That uh the patient's date of birth is.
[CUSTOMER][NEUTRAL] [PII]. 1st name is [PII], last name is [PII].
[AGENT][NEUTRAL] And date of service and bill charges?
[CUSTOMER][NEUTRAL] 7 1823 total charges.
[CUSTOMER][NEUTRAL] $5,134 even.
[AGENT][NEUTRAL] OK, it looks like the claim was received on.
[AGENT][NEUTRAL] [PII], processed on the same day.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] The outpatient benefit for the calendar year has been met dollar amount.
[CUSTOMER][NEUTRAL] OK, actually, uh, you know, I am looking for the, uh, appe status. The appeal was sent on.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, um, let me see if we received it.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK, and that was for [PII] is the date of service, right?
[CUSTOMER][NEUTRAL] The service OK [PII], yes.
[AGENT][NEUTRAL] Uh, it looks like we were requesting another.
[AGENT][NEUTRAL] include a copy of the itemized bill with diagnosis and explanation of benefits from primary insurance.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] OK, so
[CUSTOMER][NEUTRAL] But you haven't received a bill?
[AGENT][NEUTRAL] Yes, we did receive the appeal.
[CUSTOMER][NEUTRAL] OK, so.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] What is the timely funding to send the primary EOB?
[AGENT][NEGATIVE] Uh, there's no timely filing for that.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] And also you're sure that uh you haven't received the primary EOB yet, right?
[AGENT][NEUTRAL] Uh let me check this.
[AGENT][NEUTRAL] Um, let's see.
[AGENT][NEUTRAL] Um, yes, no, it doesn't look like we received an actual copy of the primary EOB, like just a remittance.
[AGENT][NEUTRAL] But
[CUSTOMER][NEUTRAL] OK. And the uh what is the fax number?
[AGENT][NEUTRAL] Fax number is [PII].
[CUSTOMER][NEUTRAL] 23. OK.
[CUSTOMER][NEUTRAL] And the uh same claim number right? 356349.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, and do you have a call reference number?
[AGENT][NEUTRAL] Call reference is my name, [PII], first initial to last name [PII], and today's date.
[CUSTOMER][POSITIVE] OK. Uh, thank you so much. That's all I need for today and have a very blessed day.
[AGENT][POSITIVE] Thank you for calling APL. You as well. Bye-bye.