AccountId: 011433970860
ContactId: c080f3b1-0351-4613-9c2f-542f5c64164b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 475220 ms
Total Talk Time (AGENT): 89738 ms
Total Talk Time (CUSTOMER): 93127 ms
Interruptions: 1
Overall Sentiment: AGENT=0.8, CUSTOMER=-1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/12/c080f3b1-0351-4613-9c2f-542f5c64164b_20250612T21:49_UTC.wav
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[AGENT][POSITIVE] Good Afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hey, hi, this is [PII] calling you from provider's office to check on our team status.
[AGENT][NEUTRAL] OK, sure. I can assist you with claim status, Mr. [PII]. And may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Sure. It's [PII].
[AGENT][NEUTRAL] Thank you. May I have the patient's policy number?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] 02405
[CUSTOMER][NEUTRAL] I'm sorry. It's 024045.
[AGENT][NEUTRAL] I set up
[CUSTOMER][NEUTRAL] Uh, uh, let me start it from the beginning. It's 02404596. M as in Mike, L as in Lima.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 8
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And what's the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] And the date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. And what's the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] It's for
[CUSTOMER][NEUTRAL] [PII] and the bill amount is $542 even.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me see if I can find this claim and that was [PII], correct?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][POSITIVE] Correct.
[AGENT][POSITIVE] OK. Thank you.
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] OK, so it looks like we received the claim on [PII].
[AGENT][NEGATIVE] And we process [PII] and the claim was denied. The reason for this denial is that office visits are not.
[AGENT][NEUTRAL] Uh cover under the member's plan.
[CUSTOMER][NEUTRAL] Mhm. Can I have the claim number?
[AGENT][NEUTRAL] Sure. That is um 358.
[AGENT][NEUTRAL] 5393.
[CUSTOMER][NEUTRAL] Mhm. And upon checking that, ma'am, uh, we have received the details, uh, one month ago to we call and verified about this, but it was the same reason but we requested for an EOB.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Hm.
[CUSTOMER][NEGATIVE] But we haven't received any of it through this one.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] What's the fax number?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][POSITIVE] Yes, correct, ma'am.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] Do you mind holding for me while I send this out to you while I got you on the line?
[CUSTOMER][NEUTRAL] Yeah, sure.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you for holding and being patient for. Yeah, I went ahead and send that over to you. Should be there in a few minutes.
[CUSTOMER][NEUTRAL] Yeah Malanur college now.
[AGENT][NEUTRAL] Is there anything else I may help you with today?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] That's it, ma'am. Can we have the call reference number?
[AGENT][NEUTRAL] Uh, we don't have a reference numbers. You can use my name in today's date if you will.
[CUSTOMER][NEUTRAL] Would you place that will be on like.
[AGENT][NEUTRAL] Sure, that's S as in [PII], last initial M [PII].
[CUSTOMER][POSITIVE] Got that, ma'am. That's it for today. You have been very helpful to me and you have a wonderful day ahead. Thank you for assisting me.
[AGENT][NEUTRAL] Yes, sir.
[AGENT][POSITIVE] You're welcome. Have a good afternoon. Bye-bye.