AccountId: 011433970860
ContactId: c6a89dd7-74c6-4d53-a678-46c675dc7a02
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 233960 ms
Total Talk Time (AGENT): 99345 ms
Total Talk Time (CUSTOMER): 82954 ms
Interruptions: 1
Overall Sentiment: AGENT=1.4, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/03/c6a89dd7-74c6-4d53-a678-46c675dc7a02_20250403T13:23_UTC.wav
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[AGENT][NEUTRAL] Call AVL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, good morning. My name is [PII].
[CUSTOMER][NEUTRAL] And I'm calling in reference to a claim that I need help with.
[AGENT][NEUTRAL] Sure, [PII], I could assist you with that. Can I have a callback number for you and that policy number?
[CUSTOMER][NEUTRAL] Yes, so my direct line is [PII] and the patient's policy number is 021985. No, I'm sorry, let me start over. It's 021-984-56 M as in Mary, L as in Lima 8.
[AGENT][POSITIVE] Thank you. And what was your name again?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII], could you verify that patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII] Date of birth is [PII].
[AGENT][NEUTRAL] And you're calling in regards to a claim, a claim that's already been submitted or a claim that you're trying to submit?
[CUSTOMER][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] It's already been submitted.
[AGENT][NEUTRAL] And what is the date of service?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] What is your procedure code?
[CUSTOMER][NEUTRAL] One second.
[CUSTOMER][NEUTRAL] 00813
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] So this claim was received [PII]. It was processed [PII]. There was no payment made on this claim, and the reason why there was no payment, [PII], is because we have received the primary explanation of benefits that was submitted with your claim. however, the explanation of benefits received does not list the amount applied towards the deductible, co-pay or the co-insurance. So you need to submit to us a more detailed EOB from the primary insurance company.
[CUSTOMER][NEUTRAL] OK, no problem. Um, can this information be faxed or needs to be mailed?
[AGENT][NEUTRAL] No, it could be faxed to us and make sure that you put that claim number on there.
[AGENT][NEUTRAL] You spell your name [PII]?
[CUSTOMER][NEUTRAL] OK, and let me just verify.
[CUSTOMER][POSITIVE] Yes, correct, I.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Um, and the, the claim number, is it 352-7151?
[AGENT][NEUTRAL] Let me verify for you.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] 352-715-1 is correct.
[CUSTOMER][NEUTRAL] OK, and do you need me to submit the claim form again or just submit the EOB with the claim number?
[AGENT][NEUTRAL] Just the updated EOB with the claim number. Make sure you put the claim number so we'll know that that's in reference to that claim.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][POSITIVE] OK, no worries. Perfect. And um may I have the fax number?
[AGENT][NEUTRAL] Is there anything else that I can assist you with?
[CUSTOMER][NEUTRAL] Yes, just the fax number.
[AGENT][NEUTRAL] So the fax number would be [PII].
[AGENT][POSITIVE] Make sure that I'm giving you the correct one.
[AGENT][NEUTRAL] 365942318773659423 attention claims department.
[CUSTOMER][NEUTRAL] OK, and you know what, let me just repeat that. I'm sorry. [PII]?
[AGENT][POSITIVE] Yes, that is correct.
[CUSTOMER][POSITIVE] Perfect and I'm sorry, your name again was?
[AGENT][NEUTRAL] My name is [PII] and today's date as a reference because unfortunately [PII] we don't provide reference numbers.
[CUSTOMER][POSITIVE] That's fine. Thank you so much for your help. I appreciate it. You you have a great day.
[AGENT][POSITIVE] Thanks for calling APL. You have a great one as well. Goodbye.
[CUSTOMER][NEUTRAL] No