AccountId: 011433970860
ContactId: e2310935-12c5-47dd-8b15-a199a3cc5ba2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 265519 ms
Total Talk Time (AGENT): 110646 ms
Total Talk Time (CUSTOMER): 81781 ms
Interruptions: 4
Overall Sentiment: AGENT=1.6, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/12/e2310935-12c5-47dd-8b15-a199a3cc5ba2_20250512T16:44_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] from the provider's office. How are you today?
[AGENT][NEUTRAL] I'm fine. And did you say your name is [PII]?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] OK. How can I, hi, hi, [PII], how can I help you today?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah, and I'm looking for a client status so today.
[AGENT][NEUTRAL] OK, you have one claim, is that correct? To check claim status on?
[CUSTOMER][NEUTRAL] Oh. Yeah.
[AGENT][POSITIVE] Yes, I can help you with that. And what is your callback number?
[CUSTOMER][NEUTRAL] Yep, callback number is [PII].
[AGENT][NEUTRAL] Thank you. And the member's policy number, please?
[CUSTOMER][NEUTRAL] That's.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Member's policy number was 01979937.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] OK, thank you. Give me one moment, I need to get the member's information pulled up, please.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And [PII], any information that is provided today will be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth?
[CUSTOMER][NEUTRAL] patient's name is [PII] and the date of birth is [PII].
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] It.
[AGENT][NEUTRAL] And what is the date of service and total bill amount, please?
[CUSTOMER][NEUTRAL] Date of service is [PII] and the total bill amount is $621 621.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Go
[CUSTOMER][NEUTRAL] that.
[CUSTOMER][NEUTRAL] Like.
[AGENT][NEUTRAL] OK, so I do see that this claim was received, [PII]. The received date was [PII].
[CUSTOMER][NEUTRAL] This is.
[AGENT][NEGATIVE] It was processed and denied on [PII].
[AGENT][NEUTRAL] The claim number is 3581785.
[CUSTOMER][NEUTRAL] For the money.
[AGENT][NEUTRAL] And the denial remarks. There are 21 state's office visits are not covered by the above number policy. The member's policy does not cover office visits, [PII], and the other remark for the other two codes states to please provide copies of your explanation of benefits from your primary insurance carrier.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Oh, then can I get the payer ID?
[AGENT][NEUTRAL] 60801. Again, it's the primary insurance company's explanation of benefits that we need.
[CUSTOMER][NEUTRAL] OK. Can I get the call reference number?
[AGENT][NEUTRAL] And then, yes, it would be my name that I gave you along with today's date and if you need a copy of this explanation of benefits with these remarks, you can print it by going to our portal at [PII].
[CUSTOMER][NEUTRAL] OK. Can I get your name?
[AGENT][NEUTRAL] Again, my name is [PII].
[CUSTOMER][POSITIVE] OK, then thank you. Thank you for your assistance. I wonderful day for you.
[AGENT][POSITIVE] Well, you're welcome. Yes, sir. Is there anything else that I can help you with today?
[CUSTOMER][NEUTRAL] No, everything is fine for today.
[AGENT][POSITIVE] OK, well, have a wonderful day, [PII], and thank you again for calling APL.
[CUSTOMER][NEUTRAL] Yeah bye.
[AGENT][NEUTRAL] Bye bye.