AccountId: 011433970860
ContactId: c531b2dd-6b78-4390-8d50-a1f9476274f7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 292500 ms
Total Talk Time (AGENT): 121688 ms
Total Talk Time (CUSTOMER): 78394 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/18/c531b2dd-6b78-4390-8d50-a1f9476274f7_20250218T15:02_UTC.wav
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[AGENT][POSITIVE] Good morning. Thanks for calling APL. This is speaking. May I help you?
[CUSTOMER][NEUTRAL] Yes, hi, good morning. My name is [PII]. I'm calling from UC Davis. I'm calling to get additional information on a denial for one of our patients' claims.
[AGENT][NEUTRAL] OK, I can verify that, [PII], and what is the policy number, please?
[CUSTOMER][NEUTRAL] Yes, I have policy number 2471754.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, and do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] Yes, it is area code [PII], and that's my direct line.
[AGENT][NEUTRAL] OK, thank you. And verify the patient's name, date of birth.
[CUSTOMER][NEUTRAL] It's for [PII] [PII].
[AGENT][NEUTRAL] OK, and the date of service and the amount of the charge.
[CUSTOMER][NEUTRAL] Yes, this is going to be for, um, give me one second here. Data service is 5, I'm sorry, [PII] for the billed amount of $988.
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And you're calling from?
[CUSTOMER][NEUTRAL] UC Davis Medical Center.
[AGENT][NEUTRAL] Uh, let's see.
[AGENT][NEUTRAL] See
[AGENT][NEUTRAL] It looks like initially the claim was processed as um
[AGENT][NEGATIVE] We are unable to assign benefits to the provider of record due to a discrepancy with the provider's tax ID number. A letter has been mailed to the provider with instructions on resolving this discrepancy.
[AGENT][NEUTRAL] This car
[CUSTOMER][NEUTRAL] OK, what does that mean? Is it because the providers out of network with you guys or?
[AGENT][NEUTRAL] Well, we don't have a network, uh,
[AGENT][NEUTRAL] But I'm not sure. I could probably transfer you to an examiner and they can explain as far as that uh denial code, but it looks like it was received again.
[AGENT][NEUTRAL] And the claim was processed one moment.
[AGENT][NEUTRAL] Uh,
[AGENT][NEUTRAL] Like they processes um.
[AGENT][NEUTRAL] Wait on information to confirm employers' association, um, to confirm eligibility.
[AGENT][NEUTRAL] Let me one moment let me see what this know this was for.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] OK. I'll have to get your information and uh someone would have to give you a call back as far as what that discrepancy means. Um, Ms. [PII], the [PII] is a good callback number?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, that's my direct line.
[AGENT][NEUTRAL] OK, I'll send a request to, I guess the person that's handled that so they can give you a call back.
[CUSTOMER][NEUTRAL] OK. And um do you uh provide reference call number for our call, please?
[AGENT][NEUTRAL] Uh, no, ma'am. We don't give reference numbers, but you may use my name on today's date.
[CUSTOMER][NEUTRAL] OK, and how do you spell your first name and do you have a middle initial?
[AGENT][NEUTRAL] Uh, it's [PII], last initial [PII].
[CUSTOMER][NEUTRAL] OK, and do you know when they might be able to call me back today or the next day or?
[AGENT][NEUTRAL] Um, not sure. What would be a good callback, [PII]?
[CUSTOMER][NEUTRAL] Um, any time is fine. I work from [PII], uh, Pacific Central Time.
[AGENT][NEUTRAL] You said [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, I will send a request for someone to give you a call back, Ms. [PII].
[CUSTOMER][POSITIVE] OK, alright, thank you so much I appreciate it have a wonderful day.
[AGENT][POSITIVE] Uh, yes, ma'am. You too and thank you for calling APL. Bye.
[CUSTOMER][NEUTRAL] Mhm bye bye.