AccountId: 011433970860
ContactId: b3d3caf9-a8e8-4e1e-b455-bc55231d0124
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 192679 ms
Total Talk Time (AGENT): 75289 ms
Total Talk Time (CUSTOMER): 74022 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/22/b3d3caf9-a8e8-4e1e-b455-bc55231d0124_20250522T14:29_UTC.wav
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[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I'm calling for claim status.
[AGENT][POSITIVE] All right, [PII], I'm happy to check on a claim. Do we have a policy number?
[CUSTOMER][NEUTRAL] Yes, we do. The policy number is 02579973ML8.
[AGENT][POSITIVE] All right, thank you for that. Give me just one moment here.
[AGENT][NEUTRAL] And can I get patient's name and date of birth?
[CUSTOMER][NEUTRAL] The patient is [PII], [PII].
[AGENT][NEUTRAL] Thank you. What is the date of service?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] The the bill amount.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Hold on.
[CUSTOMER][NEUTRAL] Is 164.
[AGENT][NEUTRAL] OK, write it down here and you said [PII], right?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] Oh my [PII]
[CUSTOMER][NEUTRAL] Well I told I told.
[AGENT][NEUTRAL] OK, so it looks like we did get a claim [PII] for the state of service. It looks like it was denied requesting the primary EOB.
[CUSTOMER][NEGATIVE] OK, yeah, the, the explanation of benefits says it doesn't clearly shows the patient responsibility but it's on there so I don't understand.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Why is he saying that?
[AGENT][NEGATIVE] It says we received the explanation of benefits that was submitted with the claim. However, the explanation of benefits received does not list the amounts applied towards deductible, co-pay, or co-insurance.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] But it does it it shows the um.
[CUSTOMER][NEUTRAL] A lot amount 3539 and it shows that it was applied to the co-pay over on the side. I'll just send a different type of EOB maybe that um that'll work there. Could I fax it?
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Yeah, absolutely. Do you need the fax number?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, it's gonna be [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] So it would
[CUSTOMER][NEUTRAL] [PII]. Do you give reference numbers, [PII]?
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Yeah, absolutely. Call references my name with today's date, so you can use my name [PII], last initial [PII] and then today's date.
[CUSTOMER][POSITIVE] OK, thank you for your help.
[AGENT][POSITIVE] You're welcome. Have a good one.
[CUSTOMER][NEUTRAL] You as well bye.
[AGENT][NEUTRAL] Bye-bye.