AccountId: 011433970860
ContactId: e0999802-4179-47a7-9c0f-5de57a400bde
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 348690 ms
Total Talk Time (AGENT): 126130 ms
Total Talk Time (CUSTOMER): 103675 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/02/e0999802-4179-47a7-9c0f-5de57a400bde_20250602T17:59_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey [PII], my name is [PII]. I'm calling from uh provider's office just needing um status on a claim please.
[AGENT][NEUTRAL] OK, I can help you with claim status. [PII], can I get a good call back number in case we get disconnected?
[CUSTOMER][NEUTRAL] Yep it's [PII].
[AGENT][NEUTRAL] And what's the policy number?
[CUSTOMER][NEUTRAL] Um, policy number is
[CUSTOMER][NEUTRAL] 0236152
[CUSTOMER][NEUTRAL] 6 ML 8.
[AGENT][NEUTRAL] OK, give me just a moment to look that up.
[AGENT][NEUTRAL] Can I get the patient's name and date of birth please?
[CUSTOMER][NEUTRAL] Yep, it's [PII].
[AGENT][POSITIVE] Thank you so much.
[AGENT][NEUTRAL] And do you have the claim number or the date of service?
[CUSTOMER][NEUTRAL] Yeah, I have the um the data service is [PII].
[CUSTOMER][NEUTRAL] Um, it's a bill amount of $28.28.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me look that up.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And you said [PII], correct?
[CUSTOMER][POSITIVE] Mm. Correct.
[AGENT][NEUTRAL] OK, just want to make sure.
[CUSTOMER][NEUTRAL] Just
[AGENT][NEUTRAL] I'm not seeing anything for [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, and give me just a moment because, give me just one moment, let me see something real quick.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK and I see why.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, it looks like that policy is a lapsed policy number. Um, let me go ahead and make sure that it's in, because sometimes I'll put it in the right, the correct policy. Let me go ahead and check that real quick.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Alright. And would you like the new policy number?
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] OK, it's 02.
[AGENT][NEUTRAL] 53.
[AGENT][NEUTRAL] 8172.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It looks like we received that claim on [PII]. It was processed on [PII] I'm sorry, [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEGATIVE] It looks like it was denied, let me see why.
[AGENT][NEUTRAL] It appears that the primary uh carrier has requested additional information um so we'll need you to submit the corrected explanation of benefits. So the primary insurance uh requested additional information.
[CUSTOMER][NEUTRAL] Right
[CUSTOMER][NEUTRAL] OK. Um.
[CUSTOMER][NEUTRAL] You see something I
[CUSTOMER][NEUTRAL] I know we have to.
[CUSTOMER][NEUTRAL] OK, they, they were wanting office notes which we did submit.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, and it was reprocessed on [PII].
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And did you submit, did they give you a new explanation of benefits or an EOB?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Yeah, I, I have it, um.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Let me pull it up here. Let me see.
[CUSTOMER][NEUTRAL] So that's all you're needing is their updated EUB.
[AGENT][POSITIVE] Correct and I can give you the claim number to put on there as well um whenever you're ready.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, um, go ahead.
[AGENT][NEUTRAL] The claim number is 35.
[AGENT][NEUTRAL] 93102.
[CUSTOMER][NEUTRAL] OK, so 359-3102. Um, can I fax this?
[AGENT][NEUTRAL] Yes, ma'am, you can. Do you have our fax number?
[CUSTOMER][NEUTRAL] No, I do not.
[AGENT][NEUTRAL] OK. It's 877.
[AGENT][NEUTRAL] 365.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 942 3.
[CUSTOMER][NEUTRAL] OK, [PII] and may get attention to that claim number?
[AGENT][NEUTRAL] Attention to claims department.
[CUSTOMER][NEUTRAL] Claims department, OK, um, OK, and um, would there be a reference number then for a call today?
[AGENT][NEUTRAL] So we don't have reference numbers, but you can use my name and last initial in today's date. So [PII], and today's date.
[CUSTOMER][POSITIVE] OK. All right. I do appreciate it. Thank you so much.
[AGENT][POSITIVE] Great, thank you for calling APL have a great day.
[CUSTOMER][POSITIVE] Thank you. You too. Bye.