AccountId: 011433970860
ContactId: b6b2c3ee-535a-4e12-a1ae-742bba282325
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 242429 ms
Total Talk Time (AGENT): 71062 ms
Total Talk Time (CUSTOMER): 66305 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/01/b6b2c3ee-535a-4e12-a1ae-742bba282325_20250501T14:48_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] from Infinite Health Collaborative. I was wondering if I could just check the status of some claims today for a member.
[AGENT][NEUTRAL] Hey, [PII], I can help you with claim status. Do you have a good callback number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you. And do you have the policy number of the patient?
[CUSTOMER][NEUTRAL] 2452066
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] And date of service and bill charges?
[CUSTOMER][NEUTRAL] 25 of 23 for $418.
[CUSTOMER][NEUTRAL] Then I have another date. Do you want that one right away as well or no?
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] I don't have anything for 25. What was the other date?
[CUSTOMER][NEUTRAL] 35 for the same bill amount.
[AGENT][NEUTRAL] I don't have anything for that date either, but it looks like this policy wasn't in effect until
[AGENT][NEUTRAL] [PII]. Let me see if there's another policy number.
[CUSTOMER][NEUTRAL] With this, so did the policy number change in 2025?
[AGENT][NEUTRAL] Um, you said 25-20-23 as the date of service?
[CUSTOMER][NEUTRAL] No, 25 of 25.
[AGENT][NEUTRAL] Uh oh, OK.
[AGENT][NEUTRAL] OK, what were the bill charges for 25?
[CUSTOMER][NEUTRAL] $418.
[AGENT][NEUTRAL] OK, looks like we received it, um.
[AGENT][NEUTRAL] 3 [PII]. Process 312, 2025.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] The office visits not covered under the policy?
[AGENT][NEUTRAL] And, and then the insured's primary provided full benefits on the other charge. So no benefits were payable.
[CUSTOMER][NEUTRAL] So if office visit is not covered, is that members responsibility?
[AGENT][NEUTRAL] We're a secondary policy so we don't determine member responsibility.
[CUSTOMER][NEUTRAL] OK, do you by chance, would you be able to send me a copy of the EOB you guys have for your, your processing?
[AGENT][NEUTRAL] We just
[AGENT][NEUTRAL] OK. What's your fax number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And then did you say there was another date of service?
[CUSTOMER][NEUTRAL] Um, 35 of $25 for $418.
[AGENT][NEUTRAL] OK. Same patient.
[CUSTOMER][NEUTRAL] Yep.
[AGENT][NEUTRAL] Uh, that one I don't have on file.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Um, OK, sounds good. That is all that I need for today.
[AGENT][POSITIVE] OK, well thank you for calling APL. I hope you have a good day.
[CUSTOMER][POSITIVE] Thanks you too.