AccountId: 011433970860
ContactId: d8b8b28e-cacc-4c20-ab0f-f6ac8d68865a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 326690 ms
Total Talk Time (AGENT): 131444 ms
Total Talk Time (CUSTOMER): 68805 ms
Interruptions: 1
Overall Sentiment: AGENT=1.1, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/14/d8b8b28e-cacc-4c20-ab0f-f6ac8d68865a_20250114T19:02_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII]. I'm calling from provider's office checking on a claim status.
[AGENT][NEUTRAL] OK. Did you say that your name is [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And you're needing to check your claim status on one patient. Is that correct, [PII]?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Yes, ma'am, I can help you with that. And first off, what is a good callback number for you please?
[CUSTOMER][NEUTRAL] Really
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And [PII], what is the member's policy number?
[CUSTOMER][NEUTRAL] 2, sorry, 02372882. M as in Mike, L as in Lima, 7.
[AGENT][POSITIVE] Thank you, one moment.
[CUSTOMER][NEUTRAL] that
[CUSTOMER][NEUTRAL] It's come down.
[AGENT][NEUTRAL] Just one moment please.
[CUSTOMER][NEUTRAL] 5
[AGENT][NEUTRAL] OK, [PII], any information that I do provide for you today would be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] And what is the date of service and total build amount for her place?
[CUSTOMER][NEUTRAL] 6 1720 24 $7,986 even.
[AGENT][NEUTRAL] And you said the date of service is [PII]. Is that correct?
[CUSTOMER][POSITIVE] Correct
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] They
[AGENT][NEUTRAL] OK, so just one moment please.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so on this claim, I do see that it was received on [PII].
[AGENT][NEUTRAL] It was processed on [PII]. No, I'm so sorry. Give me just one moment.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] I'm very sorry. Let's start that again. I mean, that was an incorrect date.
[CUSTOMER][NEUTRAL] And
[AGENT][NEUTRAL] This claim was received on [PII].
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] It was processed and denied on [PII].
[AGENT][NEUTRAL] The claim number is 347.
[AGENT][NEUTRAL] 892 7.
[AGENT][NEUTRAL] And the reason for the denial states to please provide copies of the explanation of benefits from the primary insurance carrier.
[CUSTOMER][NEUTRAL] Can I get the fax number, please?
[AGENT][NEUTRAL] Yes, ma'am. It's [PII].
[AGENT][NEUTRAL] 365.
[AGENT][NEUTRAL] 942 3.
[CUSTOMER][NEUTRAL] OK, and is there any timely filling for sending primary?
[AGENT][NEUTRAL] No, ma'am.
[AGENT][NEUTRAL] And then we also, once the claim has been processed, [PII], if you need a copy of the explanation of benefits for APL, you may get that by going to our portal at [PII].
[CUSTOMER][POSITIVE] Thank you. What
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] OK. Uh.
[CUSTOMER][NEUTRAL] What will be the call.
[AGENT][NEUTRAL] The call reference number will be my name that I gave you along with today's date.
[CUSTOMER][POSITIVE] Thank you so much. That's all for now. Thank you.
[AGENT][POSITIVE] OK, well, you're very welcome. So if that's all I can help you with, [PII]. Thank you again for calling APL and I hope you have a very nice afternoon.
[CUSTOMER][POSITIVE] You too. Thank you.
[AGENT][POSITIVE] Oh, thank you also.
[AGENT][NEUTRAL] Bye-bye.
[CUSTOMER][NEUTRAL] Bye-bye.