AccountId: 011433970860
ContactId: bcdb811e-6609-4395-8629-a10f73cb92ea
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 290899 ms
Total Talk Time (AGENT): 104920 ms
Total Talk Time (CUSTOMER): 82371 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/14/bcdb811e-6609-4395-8629-a10f73cb92ea_20250514T13:14_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yeah, hi, [PII]. This is [PII] calling from provider office to check on a claim.
[AGENT][NEUTRAL] OK, [PII], you have one claim to check status on, is that correct?
[CUSTOMER][NEUTRAL] Uh yes, that is correct. I just, before we go ahead, we would like to inform you that this call may be recorded. So is that OK with you?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] That's fine. And [PII], what is your callback number, please?
[CUSTOMER][NEUTRAL] Our callback number, it's going to be [PII]. And that is an extension [PII].
[AGENT][NEUTRAL] Thank you and the member's policy number please, [PII].
[CUSTOMER][NEUTRAL] Sure, the policy number here I have, it's
[CUSTOMER][NEUTRAL] 02365644 M. Mike Lima 8.
[AGENT][NEUTRAL] OK, thank you. One moment please.
[AGENT][NEUTRAL] And any information that I provide today will be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth, please, [PII]?
[CUSTOMER][NEUTRAL] Patient name that I have is [PII], and the date of birth is [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And what is the data service and total bill amount, please?
[CUSTOMER][NEUTRAL] Well, it's for [PII] and the total bill amount is $4,149 even.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, so this claim was received, the received date was [PII].
[AGENT][NEUTRAL] Processed and denied on [PII].
[AGENT][NEUTRAL] The claim number is 3,592,560.
[AGENT][NEUTRAL] And the reason for the denial state, please provide copies of the explanation of benefits from your primary insurance carrier.
[AGENT][NEUTRAL] We need the primary insurance EOB.
[CUSTOMER][NEUTRAL] Um, OK.
[CUSTOMER][NEUTRAL] OK. Thanks so much, [PII], for this information. And can you also help me with the um fax number or mailing address to send this uh UB?
[AGENT][NEUTRAL] The claims, the claims fax number is going to be, are you ready?
[CUSTOMER][POSITIVE] Ah yes, please go ahead.
[AGENT][NEUTRAL] [PII] attention claims department.
[CUSTOMER][NEUTRAL] OK. And is there any time limits to uh submit this UOB?
[AGENT][NEGATIVE] There is not.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then once the claim.
[CUSTOMER][POSITIVE] OK. Thank you so much for all the information.
[AGENT][NEUTRAL] Yes, and if you need a copy of this explanation of benefits with that remark on it, [PII] that I read to you, you can actually print that from our portal using that claim number by going to [PII].
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. Um, OK, [PII]. Thank you so much for all the information. And, uh, uh, before we go ahead, can, can you confirm the claim number and also provide me the call reference number, please?
[AGENT][POSITIVE] Well, you're welcome.
[AGENT][NEUTRAL] The claim number is 3,592,560.
[AGENT][NEUTRAL] And my name and today's date will be the reference number.
[CUSTOMER][POSITIVE] OK. OK, [PII]. Thank you so much for your help. Uh, have a great day. Bye-bye. Take care.
[AGENT][POSITIVE] Well, if that is all that I can help you with today, then thank you again for