AccountId: 011433970860
ContactId: c1cf7dd1-0be1-40c9-b5b9-2f5131125e86
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 192259 ms
Total Talk Time (AGENT): 73368 ms
Total Talk Time (CUSTOMER): 63678 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=2.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/21/c1cf7dd1-0be1-40c9-b5b9-2f5131125e86_20250421T14:01_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from provider's office, and could you help me with the claim status?
[AGENT][POSITIVE] OK, I'll be more than happy to help you with the claim that has been and how many claims do you have in total today?
[CUSTOMER][NEUTRAL] I have only one client, ma'am.
[AGENT][NEUTRAL] All right. May I have a good contact number in case we're disconnected and the policy number?
[CUSTOMER][NEUTRAL] Sure. The callback number is [PII]. That's a direct line and the policy ID is
[CUSTOMER][NEUTRAL] 02519728.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] Can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] And his first name is [PII], last name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. May I have the date of service and the total bill for the claim you like me to check on?
[CUSTOMER][NEUTRAL] Yes, ma'am. The date of service is [PII] and the bill amount is $6,744.79.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And can you verify the name of the provider's office on the claim?
[CUSTOMER][NEUTRAL] Yeah, it's Henderson Valley Medical Center.
[AGENT][NEUTRAL] Alright, so I'm sure you received the claim on [PII].
[AGENT][NEUTRAL] The claim number is 356.
[AGENT][NEUTRAL] 659 3.
[AGENT][NEUTRAL] And on [PII], the claim was denied requesting the explanation of benefits from primary insurance.
[CUSTOMER][POSITIVE] Yes, ma'am. Thank you so much for that. Actually, I do have the primary explanation benefits with me. Do you have any fax number to send it to?
[AGENT][NEUTRAL] Yes, you can fax it to [PII].
[AGENT][NEUTRAL] 365.
[AGENT][NEUTRAL] 942 3.
[CUSTOMER][POSITIVE] Thank you so much. May I know the attention for this one?
[AGENT][NEUTRAL] It will be attention APL claims department.
[CUSTOMER][POSITIVE] Yes, ma'am. Thank you so much for that. And do you have a call reference number for me?
[AGENT][NEUTRAL] So there's no so there's no call reference number, but you can use my name in today's date. The first initial to my last name is [PII].
[CUSTOMER][NEUTRAL] I get that.
[CUSTOMER][POSITIVE] Thank you so much for that, [PII], and uh.
[CUSTOMER][POSITIVE] Have a great day.
[AGENT][POSITIVE] You're very welcome, [PII]. Was there anything else I can assist you with today?
[CUSTOMER][POSITIVE] No, ma'am, I got all good information. Thank you so much for asking. Have a nice day.
[AGENT][POSITIVE] All right, thanks for calling APL and I hope you have a great day.
[CUSTOMER][NEUTRAL] Bye bye.