AccountId: 011433970860
ContactId: deff103d-6b30-473f-b288-21c6ec55e49a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 421709 ms
Total Talk Time (AGENT): 86333 ms
Total Talk Time (CUSTOMER): 129897 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/17/deff103d-6b30-473f-b288-21c6ec55e49a_20250617T21:53_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yeah, hi, this is [PII] calling from provider office regarding the claim status.
[AGENT][NEUTRAL] I can help you with claim status, [PII]. Can I get a good call back number in case we get disconnected?
[CUSTOMER][NEUTRAL] Yeah, sure. Our callback number is [PII].
[AGENT][NEUTRAL] And do you have the policy number?
[CUSTOMER][NEUTRAL] Yeah, sure. One moment, please. Uh loading the policy number.
[CUSTOMER][NEUTRAL] One second. Uh, meanwhile, can you help me with your initial and last name?
[AGENT][NEUTRAL] I'm sorry, what was that?
[CUSTOMER][NEUTRAL] Uh, can I know your initial and last name?
[AGENT][NEUTRAL] Oh, it's [PII].
[CUSTOMER][NEUTRAL] Yeah, thanks for that. Once again, please. It was getting loaded the patient details. One moment, please. Please bear with me.
[CUSTOMER][NEUTRAL] One moment, please. It was done.
[CUSTOMER][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Yes, here comes the member ID.
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] Can you verify the patient's name and date of birth for me, please?
[CUSTOMER][NEUTRAL] Yeah. It's list in Alvi. Date of birth [PII].
[CUSTOMER][NEUTRAL] The rate of services?
[AGENT][NEUTRAL] OK, what's the date of service?
[CUSTOMER][NEUTRAL] [PII]. Yeah, [PII] with the bill amount of $200.
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] Yes, sure.
[AGENT][NEUTRAL] And it looks like we received this claim on [PII].
[AGENT][NEUTRAL] It was processed on [PII].
[AGENT][NEUTRAL] The claim number is 35.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 45711
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And it looks like that claim was denied because we need the primary insurance explanation of benefits.
[CUSTOMER][NEUTRAL] OK. Can you help me uh with the primary ratios as the coordination of benefits?
[AGENT][NEUTRAL] Yes, we need the, we need the primary explanation of benefits. Did you need our fax number?
[CUSTOMER][NEUTRAL] OK, got it.
[CUSTOMER][NEUTRAL] Uh, no, no. Uh, we will have that. Uh, can you help me with the call reference number? We'll go with another member ID.
[AGENT][NEUTRAL] So we don't have call reference numbers, but you can use my name and last initial in today's date.
[CUSTOMER][NEUTRAL] OK, fine. Can we go with another member ID?
[AGENT][NEUTRAL] Give me just one moment. Let me close this one down.
[CUSTOMER][NEUTRAL] Yeah, sure, please.
[CUSTOMER][NEUTRAL] Uh, your initial last name is [PII] Am I correct?
[AGENT][NEUTRAL] [PII], yes, ma'am.
[CUSTOMER][NEUTRAL] OK, then. Thanks for that. Uh, whenever you're ready, let me know. I will go with the another member ID. I was just pulling it.
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][POSITIVE] Yeah, sure, please. Take your time.
[AGENT][NEUTRAL] In the next patient?
[CUSTOMER][NEUTRAL] Yeah, one second, please.
[CUSTOMER][NEUTRAL] The next member ID is?
[CUSTOMER][NEUTRAL] Yes, it's the next member ID.
[CUSTOMER][NEUTRAL] 1456234.
[AGENT][NEUTRAL] I have 1456234.
[CUSTOMER][POSITIVE] 234. Yes, you're right.
[AGENT][NEUTRAL] OK. One moment.
[CUSTOMER][NEUTRAL] Yeah, sure.
[AGENT][NEUTRAL] Can you verify the patient's name and date of birth for me, please?
[CUSTOMER][NEUTRAL] Yeah, sure. It's [PII]. Date of birth [PII].
[AGENT][NEUTRAL] And what was the date of service?
[CUSTOMER][NEUTRAL] January.
[CUSTOMER][NEUTRAL] [PII]. It's [PII] with the amount of $200.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Yes, you're right.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I'm not showing a claim on file for [PII].
[CUSTOMER][NEUTRAL] OK. It's [PII].
[AGENT][NEUTRAL] Yes, I'm not showing a claim for that data service.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. I will refund the plan. Can I get the time finding limit?
[AGENT][NEUTRAL] So we don't have timely filing limit.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, sure. We'll refund the plan.
[CUSTOMER][POSITIVE] OK, then. Thank you. Have a wonderful day. Bye for now.
[AGENT][POSITIVE] Great. Thank you for calling APL. Have a great day.
[CUSTOMER][NEUTRAL] Bye-bye.