AccountId: 011433970860
ContactId: ba6baa25-58ed-4b35-98c3-8c3562d10d23
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 266579 ms
Total Talk Time (AGENT): 105668 ms
Total Talk Time (CUSTOMER): 72232 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/06/ba6baa25-58ed-4b35-98c3-8c3562d10d23_20250206T18:19_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from provider's office. Do you know the claim status?
[AGENT][NEUTRAL] OK, yeah, I could check on a claim for you. I'm sorry, what did you say your name was?
[CUSTOMER][NEUTRAL] Yeah, [PII].
[AGENT][NEUTRAL] Could you spell that for me?
[CUSTOMER][NEUTRAL] Yeah, sure. It's [PII].
[AGENT][POSITIVE] OK, thank you for that. And then can I get a good call back number from you and just in case we're disconnected?
[CUSTOMER][NEUTRAL] Yeah, sure. It's [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Thank you. And then do you have the policy number?
[CUSTOMER][NEUTRAL] Yeah, it's
[CUSTOMER][NEUTRAL] 1262468 M as in Mike L as in Lima 8.
[AGENT][NEUTRAL] All right, thank you. And what was the name and date of birth for the insured?
[CUSTOMER][NEUTRAL] Yeah, it's [PII] and date of birth is [PII].
[AGENT][NEUTRAL] Alright, thank you for verifying that. And what was the date of service for this claim, please?
[CUSTOMER][NEUTRAL] Yeah, the data service is [PII] and total charge is $459.
[AGENT][NEUTRAL] 459. OK, thank you. One moment please.
[CUSTOMER][NEUTRAL] Yeah, sure.
[AGENT][NEUTRAL] Was this uh Holy Cross Medical Group?
[CUSTOMER][NEUTRAL] Yeah, Holy Cross Medical Group.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right, so it looks like for this claim, uh, we are missing the primary EOB.
[CUSTOMER][NEUTRAL] But uh they're stating that the in previously one of our colleague mentioned that the claim was denied they did not cover any office visits.
[AGENT][NEUTRAL] Uh, the notes that I've got here, um, office visits may not be covered, but I do see a couple of other items on this claim. Hang on, we could go over the.
[AGENT][NEUTRAL] Procedure codes.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, 99214 that is the office visit. OK, so that is the 4:59, so yeah, you are right, um, we also didn't receive that but yes, sorry about that.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Yeah, no problem.
[AGENT][NEUTRAL] Did you need the claim number?
[CUSTOMER][NEUTRAL] Yeah, may I know the claim receive date and process it, please.
[AGENT][NEUTRAL] Oh yes, give me just a moment, let me get that.
[AGENT][NEUTRAL] That was received [PII] and it was processed [PII].
[CUSTOMER][NEUTRAL] Yeah, can I get the claim number please?
[AGENT][NEUTRAL] Yes, it is 354-819-2.
[CUSTOMER][NEUTRAL] Yeah, could you please fax the the EUB.
[AGENT][NEUTRAL] Oh yes, uh, what was that fax number for you?
[CUSTOMER][NEUTRAL] Yeah, it's [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, I'm gonna read that back, make sure I heard that correctly. That was [PII].
[CUSTOMER][POSITIVE] Yeah, it's correct.
[AGENT][NEUTRAL] OK, alrighty, I will get that sent to you. You should get it here in maybe 10-15 minutes depending on how busy your machine is. Was there anything else I could help you with?
[CUSTOMER][NEUTRAL] Yeah, could you please spell your name for me?
[AGENT][NEUTRAL] Yes, it's [PII]
[CUSTOMER][NEUTRAL] Yeah, can I get the call reference please?
[AGENT][NEUTRAL] Mhm reference number would just be my first name, last initial, and today's date, uh, so my last initial is A.
[CUSTOMER][POSITIVE] Yeah thank you so much thank you so much for assisting us.
[AGENT][POSITIVE] Of course, thanks for calling APL yeah I hope you have a great rest of your day.
[CUSTOMER][POSITIVE] You too take care bye bye.
[AGENT][POSITIVE] Thank you. Bye-bye.