AccountId: 011433970860
ContactId: c5838b30-2663-4d6b-bf36-2ffc61e7229d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 305339 ms
Total Talk Time (AGENT): 125158 ms
Total Talk Time (CUSTOMER): 82616 ms
Interruptions: 2
Overall Sentiment: AGENT=0.7, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/29/c5838b30-2663-4d6b-bf36-2ffc61e7229d_20250529T12:15_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm calling from products office to check on a claim status.
[AGENT][NEUTRAL] OK, [PII], you have one claim to check status on, is that correct?
[CUSTOMER][POSITIVE] Perfect, that's right.
[AGENT][POSITIVE] Yes, I can help you with that. And [PII], what is your callback number?
[CUSTOMER][NEUTRAL] It's [PII]. It's a direct line?
[AGENT][NEUTRAL] Thank you and what is the member's policy number, please?
[CUSTOMER][NEUTRAL] Yeah, and the member ID is 02359305.
[AGENT][NEUTRAL] Thank you. One moment please, [PII], while I get the member's information pulled up.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] That's right.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And I want any information that is provided today will be a verification of benefits and not guarantee a payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] Patient name is [PII] and date of birth is [PII].
[AGENT][NEUTRAL] Thank you and what is the date of service and total bill amount?
[CUSTOMER][NEUTRAL] And the date of service is
[CUSTOMER][NEUTRAL] [PII] for total amount, $826 even.
[AGENT][NEUTRAL] 826. Is that correct?
[CUSTOMER][POSITIVE] 826. Perfect, that's right.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] OK, so this claim was received. The received date was for [PII] and it was processed and denied the same day.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] The claim number?
[CUSTOMER][NEUTRAL] 25 to 725.
[AGENT][NEUTRAL] It's 358.
[AGENT][NEUTRAL] 354 2.
[CUSTOMER][NEUTRAL] So the.
[AGENT][NEUTRAL] And the reason for the denial on this island is that we are in need of the primary insurance company's explanation of benefits.
[AGENT][NEUTRAL] [PII], are you still there?
[CUSTOMER][NEUTRAL] Yeah, one more moment.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Can I get the mailing address to submit the primary OB?
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]. That's the same address as claims and put to attention claims department.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Can I get the payer ID?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 60801.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Can I get the time limit?
[AGENT][NEGATIVE] No timely filing limits.
[AGENT][NEUTRAL] And if you need a copy of that explanation of the
[CUSTOMER][NEUTRAL] And could you please spell out your name?
[AGENT][NEUTRAL] First, any info if you need a copy of this explanation of benefits, you can print that directly from our portal now that you have the claim number by going to [PII] and my name in today's date will be your call reference number. Again, my name is [PII]
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] [PII], right?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] 7.
[CUSTOMER][NEUTRAL] Can I get your first and your last name?
[AGENT][NEUTRAL] [PII]. And can you spell your name?
[CUSTOMER][NEUTRAL] It's [PII], and first initial to my last name is [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And is there anything else, [PII] that I can help you with today?
[CUSTOMER][NEUTRAL] And
[CUSTOMER][POSITIVE] And that's all about today. Thanks for your assistance. Have a great day.
[AGENT][POSITIVE] Well, you're welcome. Yes, [PII]. I hope you have a nice day too, and thank you for calling APL.
[CUSTOMER][POSITIVE] Thank you, bye bye.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Bye bye.
[AGENT][NEUTRAL] Bye bye.