AccountId: 011433970860
ContactId: c0c1d29f-73da-4437-8d32-4b14b96a5663
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 324859 ms
Total Talk Time (AGENT): 70051 ms
Total Talk Time (CUSTOMER): 144103 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/21/c0c1d29f-73da-4437-8d32-4b14b96a5663_20250321T14:29_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling ACL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling for the provider to check on additional information about the claim that has been denied. Please note this call will be monitored and recorded for quality and training purposes. How are you doing today?
[AGENT][POSITIVE] I'm doing good. How about you?
[CUSTOMER][POSITIVE] Doing good. Thank you for asking. Can I please get your name?
[AGENT][NEUTRAL] My name is [PII]. It's [PII]
[CUSTOMER][NEUTRAL] Uh, can you repeat, please?
[AGENT][NEUTRAL] Uh [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, [PII], I can help you with that claim status. Um, can I get a good call back number for you?
[CUSTOMER][NEUTRAL] Sure. [PII]. It's a direct line.
[AGENT][NEUTRAL] OK, thank you. What's the policy number of the patient?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Indiana.
[CUSTOMER][NEUTRAL] 02260440.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Do you have the patient name and date of birth?
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Yes. So first name is [PII]
[CUSTOMER][NEUTRAL] Last name is [PII], which is [PII]
[CUSTOMER][NEUTRAL] Date of birth [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Um, let's see
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] And
[AGENT][NEUTRAL] And what is the date of service for that claim?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Date of service. It's [PII]. And just a second for the bill amount.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] The
[CUSTOMER][POSITIVE] Thank you for waiting. Just 1 2nd.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][POSITIVE] Let's go
[CUSTOMER][NEUTRAL] OK. Please check for 3, sorry, $263.31.
[AGENT][NEUTRAL] Who is the provider on that claim?
[CUSTOMER][NEUTRAL] Provider's name, it's [PII], uh no, [PII]'s last name is [PII] I can give you the PI.
[AGENT][NEUTRAL] Oh, no, that's fine.
[AGENT][NEUTRAL] OK, let me look, hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] No
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] One
[CUSTOMER][NEUTRAL] Well.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Looks like we've got a couple of duplicates.
[AGENT][NEUTRAL] So I'm looking through the claims if you'll just bear with me.
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] Mm, sure. I just want to give you one additional information. I received the dejection here which is that patient is not active for the data service. So, can you please check the patient's details for me, effective and date.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, it looks like, do, do you have a claim number for that for that?
[CUSTOMER][NEUTRAL] Yes. Mhm. Please check for 35 uh 3,569,870. That's the claim number.
[AGENT][NEUTRAL] OK, well, what is that?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] It looks like.
[AGENT][NEUTRAL] That patient terminated on [PII].
[CUSTOMER][NEUTRAL] [PII]. What was the initial effective date?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] And uh do you see any other active policy maybe?
[AGENT][NEUTRAL] Um, I did check. I do not see any other active policy.
[CUSTOMER][POSITIVE] OK. Thank you so much. That's all I wanted to verify.
[CUSTOMER][NEUTRAL] So, can I get the reference number, please? and that's all for today.
[AGENT][NEUTRAL] Um, it is my first name and my last initial is [PII], and today's date.
[CUSTOMER][NEUTRAL] What
[CUSTOMER][POSITIVE] Thank you and have a good day. Bye.
[AGENT][POSITIVE] Thank you
[AGENT][NEUTRAL] [PII], for calling APL. Have a good day.