AccountId: 011433970860
ContactId: c1c4ea1c-d005-4dd1-81ee-b50378ffdd27
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 300359 ms
Total Talk Time (AGENT): 135559 ms
Total Talk Time (CUSTOMER): 82550 ms
Interruptions: 1
Overall Sentiment: AGENT=1.2, CUSTOMER=1.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/27/c1c4ea1c-d005-4dd1-81ee-b50378ffdd27_20250527T16:46_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII].
[CUSTOMER][NEUTRAL] And I'm calling from the provider office. I'm looking for the claim status. Can you help me regarding this?
[AGENT][NEUTRAL] OK, [PII], you're needing claim status, is that correct?
[CUSTOMER][POSITIVE] Yes, that is correct.
[AGENT][POSITIVE] Yes, I can help you with that. And what is your callback number?
[CUSTOMER][NEUTRAL] Sure. It's [PII].
[AGENT][NEUTRAL] Thank you. And how many claims, [PII], do you have to check?
[CUSTOMER][NEUTRAL] Uh, one claim.
[AGENT][NEUTRAL] OK. Yes, ma'am, I can help you. And what is that policy number?
[CUSTOMER][NEUTRAL] Uh, it's 021-37723.
[AGENT][POSITIVE] Thank you, one moment please.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] And any information that I do provide for you today, [PII], will be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth?
[CUSTOMER][NEUTRAL] Patient name is?
[CUSTOMER][NEUTRAL] [PII]. Date of birth is [PII].
[AGENT][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] And what is the date of service and total bill amount?
[CUSTOMER][NEUTRAL] For that one data service is.
[CUSTOMER][NEUTRAL] [PII] bill amount is $11.06.
[AGENT][NEUTRAL] And you said the date of service is [PII], is that correct?
[CUSTOMER][POSITIVE] That is correct.
[AGENT][POSITIVE] Thank you, one moment.
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] And you said it was $11.66?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, so this claim was received on [PII] and it was processed and denied on [PII].
[AGENT][NEUTRAL] The claim number is 339-7217.
[AGENT][NEUTRAL] And this claim was denied because we need the primary insurance company's explanation of benefits.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And what is family filing to submit the issue claim?
[AGENT][NEGATIVE] There is no timely filing limit?
[CUSTOMER][NEUTRAL] And how we can submit the primer with you guys. Do you have any fax number, um, any, um,
[AGENT][NEUTRAL] The fax number is [PII]. Attention claims department.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And then once the claim has been submitted and it has been reviewed or the explanation has been excuse me, once the explanation of benefits has been received and reviewed once the claim has been processed, you can also access the explanation of benefits for us by going to our website at [PII]. That's our portal website.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][POSITIVE] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm. Mhm.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. I just need one more information. Uh, when did you receive this claim?
[AGENT][NEUTRAL] Do you do need for me to repeat that again?
[CUSTOMER][NEUTRAL] Yes, sir receive date and then I'll date. I'll just need.
[AGENT][NEGATIVE] Yes, the received date again was [PII] and denied on [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] OK, I got it. Got it. Thank you so much. I need that much information. And can I get, uh, can I get a call reference number for our call for today?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Yes, you would use my name that I gave you along with today's date.
[AGENT][NEUTRAL] And if that is all that I could help.
[CUSTOMER][POSITIVE] Thank you so much and have a good
[AGENT][POSITIVE] Uh, you too, [PII], and thank you for calling. You're welcome. Thank you for calling APL. Have a nice day.
[CUSTOMER][POSITIVE] Yes, thank you.
[CUSTOMER][NEUTRAL] You too. Bye.