AccountId: 011433970860
ContactId: bbcc8d17-0e7d-45df-b4e7-0e6e0700638a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 564469 ms
Total Talk Time (AGENT): 173091 ms
Total Talk Time (CUSTOMER): 143647 ms
Interruptions: 1
Overall Sentiment: AGENT=1, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/02/bbcc8d17-0e7d-45df-b4e7-0e6e0700638a_20250602T18:02_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm calling from calling from provider's office for claim status.
[AGENT][POSITIVE] OK, I'll be more than happy to help you with the claim status, [PII]. And how many claims do you have in total today?
[CUSTOMER][NEUTRAL] I have 2 claims
[AGENT][NEUTRAL] OK, may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure. Callback number is [PII].
[CUSTOMER][NEUTRAL] And it's a direct line.
[AGENT][NEUTRAL] Thank you for that. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] Policy number is 02560523.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Sure. Member's first name is [PII], last name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Thank you for that. And all the information provided is a verification of benefits, not a guarantee of payment. And may I have the date of service and the total bills for the claim?
[CUSTOMER][NEUTRAL] Sure, date of service is [PII]. Total bill amount is $7,893 even.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEUTRAL] Yeah, yeah
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] Can you verify the name of the provider's office on the claim?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Henrio Doctors Hospital.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, here we go.
[AGENT][NEUTRAL] And I'm showing the claim was received on [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] The claim number is 356.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] 7114.
[AGENT][NEUTRAL] And on [PII], the claim was denied, requesting the explanation of benefits from primary insurance.
[CUSTOMER][NEUTRAL] Um, have you received any primary UP from our end?
[AGENT][NEUTRAL] No, we have not, not yet.
[CUSTOMER][NEUTRAL] Hello
[CUSTOMER][NEUTRAL] Uh, can you please provide me the fax number?
[AGENT][NEUTRAL] Sure, it's [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] 942 3.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Just a second.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And call reference number is going to be different or same for the both of the accounts?
[AGENT][NEUTRAL] Um, it will be the same, my name and today's date.
[CUSTOMER][NEUTRAL] Got it.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Did any good?
[CUSTOMER][NEUTRAL] Uh, thanks for being on hold and uh.
[CUSTOMER][NEUTRAL] Should I uh tell you the member ID first?
[AGENT][POSITIVE] Sure, um, I'm ready for the next one whenever you are.
[CUSTOMER][NEUTRAL] Yes, uh, member ID is [PII] [PII].
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEUTRAL] I tell you about.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Member's first name is [PII]. Last name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Thank you. And again, all the information provided is a verification of benefits, not a guarantee of payment. And may I have the date of service and the total bills?
[CUSTOMER][NEUTRAL] Data service is [PII]. Total bill amount is $62,302 even.
[CUSTOMER][NEUTRAL] Yeah I'm sorry, you.
[AGENT][NEUTRAL] And that $62,332 even?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEUTRAL] Yeah, then they start
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And do you mind if I place you on just a brief hold while I locate the claim?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you. Hold on one moment.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] 360,687,358,664,354,240.
[AGENT][NEUTRAL] 254.
[AGENT][NEUTRAL] 2349. What is this one? Hold on.
[AGENT][NEUTRAL] 3606877.
[AGENT][NEUTRAL] 358-566-4.
[AGENT][NEUTRAL] 354.
[AGENT][NEUTRAL] 5 267 OK.
[AGENT][NEUTRAL] 36.
[AGENT][NEUTRAL] Yes
[AGENT][NEUTRAL] Well,
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] $6,037 that ain't it.
[AGENT][NEUTRAL] 664.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Hello [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Thank you so much for holding. I apologize for the wait. Did you, so when I verified, I gave $62,332. Did you mean 62,302?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, no, 302.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. So hold on one moment and let me get that for you.
[AGENT][NEUTRAL] So I'm showing we received that claim.
[AGENT][NEUTRAL] On [PII].
[AGENT][NEUTRAL] The claim number is 3542349.
[AGENT][NEUTRAL] And on [PII], the claim was denied, requesting the explanation of benefits from primary insurance.
[CUSTOMER][NEUTRAL] I do
[CUSTOMER][NEUTRAL] OK, um.
[CUSTOMER][NEUTRAL] Is uh United Healthcare is the primary?
[AGENT][NEUTRAL] Hold on one moment, let me see.
[AGENT][NEUTRAL] United Healthcare.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So the fax number is the same, right?
[AGENT][NEUTRAL] Let me double check.
[AGENT][NEUTRAL] Yes, the fax number is the same.
[CUSTOMER][POSITIVE] Got it. Thank you for the information. We'll fax the primary please.
[AGENT][POSITIVE] You're very welcome. Was there anything else I could assist you with today?
[CUSTOMER][POSITIVE] Uh, no, thank you. That's all for the day.
[AGENT][POSITIVE] Alright, thanks for calling APL. I hope you have a great day, [PII].
[CUSTOMER][POSITIVE] Thank you you too. Bye-bye.
[AGENT][POSITIVE] Thank you, bye bye.