AccountId: 011433970860
ContactId: dd732532-fd15-4fdf-8cea-5e03fbfc5f97
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 272140 ms
Total Talk Time (AGENT): 77849 ms
Total Talk Time (CUSTOMER): 73631 ms
Interruptions: 0
Overall Sentiment: AGENT=-0.3, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/15/dd732532-fd15-4fdf-8cea-5e03fbfc5f97_20250415T15:02_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hello [PII], my name is [PII]. I'm calling from a provider's office to check claim status.
[AGENT][NEUTRAL] I'm sure [PII], I can assist you with claim status. Um, first, could I get a good call back number just in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes, that's [PII].
[AGENT][NEUTRAL] Thank you. Now, I need the policy number, please.
[CUSTOMER][NEUTRAL] OK, so that's D as in Dave 437301-97.
[AGENT][NEUTRAL] OK, that's not one of our policy numbers. Do you have the member's social or I can look them up by name and date of birth?
[CUSTOMER][NEUTRAL] Uh, let me check. Seems like I had an issue before when I called and it's something else pertaining to this card. Let me look at the card real quick.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] So you need the policy number which is 02466876.
[AGENT][NEUTRAL] OK, thank you. Now, please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] OK, this is for [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you. Now, I need the date of service and bill charges on the claim.
[CUSTOMER][NEUTRAL] OK, the date of service is [PII].
[CUSTOMER][NEUTRAL] The bill amount is $238.02.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and I'm waiting on my system. One moment, please.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK. Thank you for your patience. Yes, ma'am. I'm showing that this claim denied um the member.
[AGENT][NEGATIVE] Didn't qualify for benefits that week, we didn't receive, received the premium.
[AGENT][NEGATIVE] So, and we still hadn't received it, right.
[CUSTOMER][NEUTRAL] OK and.
[CUSTOMER][NEUTRAL] OK, let me make a note here. Um, is there, will we be receiving an EOB with a denial stating that in order for us to build the patient?
[AGENT][NEUTRAL] Um, yeah, one was sent out, um, let's see.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] And can you verify uh what address that was sent to just to be sure we're able to get that document.
[AGENT][NEUTRAL] Yes, ma'am. It was sent to the address on the claim, which was [PII].
[CUSTOMER][POSITIVE] OK, that's perfect.
[CUSTOMER][NEUTRAL] Alright, that's all I need. May I get a call reference number?
[AGENT][NEUTRAL] Yes, for the reference number, you can use my name and today's date. My name is [PII], um it's spelled [PII] My last initial is [PII] and today's date. Um, is there anything else I can assist you with?
[CUSTOMER][POSITIVE] No ma'am, that's it thank you so much I appreciate your time today.
[AGENT][POSITIVE] OK, thank you, [PII], for calling APL. You have a great rest of your day. Bye.
[CUSTOMER][POSITIVE] Thank you.