AccountId: 011433970860
ContactId: d06478ae-738d-4884-a645-3d21b5044649
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 216660 ms
Total Talk Time (AGENT): 65352 ms
Total Talk Time (CUSTOMER): 84189 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/08/d06478ae-738d-4884-a645-3d21b5044649_20250408T14:04_UTC.wav
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[AGENT][NEUTRAL] For calling APL, my name is [PII]. How can I assist you today?
[CUSTOMER][NEUTRAL] Good morning, [PII]. My name is [PII] and I'm calling from provider's office to check for claim status.
[AGENT][POSITIVE] I'd be happy to assist with claim status today, [PII], if I can get a good call back number for you.
[CUSTOMER][NEUTRAL] Sure, the callback number is [PII] with the extension being [PII].
[AGENT][NEUTRAL] And the policy number?
[CUSTOMER][NEUTRAL] Member's policy number is 15493.
[AGENT][NEUTRAL] Um, that's not a valid policy number.
[AGENT][NEUTRAL] Do you have a social?
[CUSTOMER][NEUTRAL] Mm, I check with them.
[CUSTOMER][NEUTRAL] Uh, no, I don't have a social number.
[AGENT][NEUTRAL] What's her name?
[CUSTOMER][NEUTRAL] My number's first name is [PII].
[CUSTOMER][NEUTRAL] Last name is spelled as [PII].
[AGENT][NEUTRAL] Do you have an address?
[CUSTOMER][NEUTRAL] Member's address is [PII].
[AGENT][NEUTRAL] And date of birth?
[CUSTOMER][NEUTRAL] Date of birth for the member is [PII].
[AGENT][NEUTRAL] Thank you for that information. Please be advised the verification of coverage is not a guarantee of payment. I do show the policy is currently active. Effective date is [PII], and let me give you the correct policy number.
[CUSTOMER][POSITIVE] Thank you, may I have that?
[AGENT][NEUTRAL] 01659616
[CUSTOMER][NEUTRAL] Got it.
[AGENT][NEUTRAL] OK, and what is, um, were you calling for inpatient or outpatient benefits?
[CUSTOMER][NEUTRAL] This is for uh
[CUSTOMER][NEUTRAL] Services rendered in an emergency situation.
[AGENT][NEUTRAL] Oh, I'm sorry, what's the claim, uh, uh, the data service for the claim, I'm sorry.
[CUSTOMER][NEUTRAL] The date of service is [PII] for the bill amount of $50 even.
[AGENT][NEUTRAL] What's your tax ID?
[CUSTOMER][NEUTRAL] I I for the provider is [PII].
[AGENT][NEUTRAL] Thank you for that. I do show the claim was denied because we need the EOB from the primary insurance.
[CUSTOMER][NEUTRAL] OK. May I know the claim number for the denied one?
[AGENT][NEUTRAL] 353-0914.
[CUSTOMER][NEGATIVE] And this was denied on
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, could you please check and let me know who is the primary payer for the member?
[AGENT][NEUTRAL] Um, that information you'll have to get from the insured.
[CUSTOMER][NEUTRAL] OK got that. Can I have the first call?
[AGENT][NEUTRAL] Reference is just my name [PII] last initial [PII], and the date and time of the call. Was there anything else I could assist with today?
[CUSTOMER][POSITIVE] That will be all for today, [PII]. Thank you for your assistance.
[AGENT][POSITIVE] Thank you for calling APL you have a good day.
[CUSTOMER][NEUTRAL] You too. Bye for now.
[AGENT][NEUTRAL] So