AccountId: 011433970860
ContactId: c0a7e946-d0f5-439f-b70c-bb912bcc5e42
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 898479 ms
Total Talk Time (AGENT): 167331 ms
Total Talk Time (CUSTOMER): 77966 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=-3.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/03/c0a7e946-d0f5-439f-b70c-bb912bcc5e42_20250603T18:23_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How may I help you today?
[CUSTOMER][NEUTRAL] The provider's office for checking.
[AGENT][NEUTRAL] Hello.
[AGENT][NEUTRAL] Is anyone there?
[AGENT][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Could you hear me now?
[AGENT][POSITIVE] I can hear you now, yes. How can I help you today?
[CUSTOMER][NEUTRAL] I'm looking for the claim status.
[AGENT][POSITIVE] OK, I'd be glad to help you go and give me your name and the member's policy number, please.
[CUSTOMER][NEUTRAL] Sure. My name is [PII].
[CUSTOMER][NEUTRAL] And the member ID is 02275794.
[AGENT][NEUTRAL] Alright, so [PII], thank you for that information. Now while I'm pulling this up, go ahead and give me a good return telephone call number, please.
[CUSTOMER][NEUTRAL] Sure. It's [PII].
[CUSTOMER][NEUTRAL] Could you please spell out your name?
[AGENT][NEUTRAL] I sure will. So [PII], it is [PII] spelled [PII] yes. And what is your patient's name and date of birth, [PII]?
[CUSTOMER][NEUTRAL] Sure. The patient's name is [PII].
[CUSTOMER][NEUTRAL] [PII], and the date of birth would be [PII].
[AGENT][NEUTRAL] Alrighty, thank you for that information. So [PII]. Now you did say you want to check status of a claim. What is that date of service?
[CUSTOMER][NEUTRAL] [PII] with the total charge amount of 2000.
[CUSTOMER][NEUTRAL] $811.60.
[AGENT][NEUTRAL] All right. So in [PII], thank you for that and hold on just a moment. Let me do some checking. Let's see.
[AGENT][NEUTRAL] Alright, total bill, yes ma'am, I do see that we do have that claim in-house for $2,811.60. And San [PII] we are needing that primary explanation of benefits from the primary insurance carrier in order to process this claim.
[CUSTOMER][NEUTRAL] OK. May I know who's the primary for this patient?
[AGENT][NEUTRAL] I'm not sure who the primary is, you would have to contact the patient.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] For to the patient?
[AGENT][NEUTRAL] Yes, ma'am. You'd have to, you'd have to find that out from the patient. I'm not sure. We're just their supplemental plan.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, but we are needing that EOB. You want that claim number, son [PII]?
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Yes, go ahead with the claim number.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] 3591406.
[CUSTOMER][NEUTRAL] OK. When was the claim received on?
[AGENT][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] Let's see.
[AGENT][NEUTRAL] Claim was received.
[AGENT][NEUTRAL] On [PII].
[CUSTOMER][NEUTRAL] And the effective date of the patient?
[AGENT][NEUTRAL] The effective date, let's see, it's going to be [PII].
[CUSTOMER][POSITIVE] Thank
[AGENT][NEUTRAL] No, ma'am, sorry. The effective date is [PII].
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK, still active, right?
[AGENT][NEUTRAL] That is correct, still active?
[CUSTOMER][NEUTRAL] OK. Can I go with the next uh member ID?
[AGENT][NEUTRAL] Yeah, is it on a different patient?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, hold on just a moment for me [PII], OK?
[CUSTOMER][NEUTRAL] OK,
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEGATIVE] No, we ain't going on to the next patient.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Hm.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Hm
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Hm.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Hm
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Hm.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Hm.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Um
[AGENT][NEUTRAL] Uh
[AGENT][NEGATIVE] That's hard.
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Ah
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] Going to the next patient? No.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Wow
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Hm hm.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] So June.