AccountId: 011433970860
ContactId: e2e404ff-cd10-46f1-a483-aa57e6e595d7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 309190 ms
Total Talk Time (AGENT): 103418 ms
Total Talk Time (CUSTOMER): 94562 ms
Interruptions: 1
Overall Sentiment: AGENT=1, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/25/e2e404ff-cd10-46f1-a483-aa57e6e595d7_20250225T20:05_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. This is [PII] calling from provider's office and you're [PII], right?
[AGENT][NEUTRAL] Uh, yes. Did you say your name is [PII]?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. Hi, [PII], there's some background noise that's making it hard for me to hear you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, can you hear me?
[AGENT][NEGATIVE] Yes, ma'am, but the background noise is making it difficult.
[AGENT][NEUTRAL] How can I help you today, [PII]?
[CUSTOMER][NEUTRAL] Uh, could you please help me with the claim status?
[AGENT][NEUTRAL] Do you have one claim to check status on?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes ma'am, I can help you with that. And what is your callback number, [PII]?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And the policy number for the patient?
[CUSTOMER][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Sorry, policy number is 02449038.
[AGENT][POSITIVE] Thank you, one moment please.
[AGENT][NEUTRAL] And then any information that I do provide for you today will be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yes, the patient's name is [PII] Date of birth is [PII].
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And the date of service and total bill amount, please.
[CUSTOMER][NEUTRAL] Date of service is [PII]. Bill amount is $1,181 even.
[AGENT][NEUTRAL] OK, that was 930 of 2024. Is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] 41181.00. Is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, this claim was received on 10-14-2023. I'm sorry, let me start over. Ja this claim was received on [PII]. It was processed and denied on the same day.
[AGENT][NEUTRAL] The claim number is 351-734-3.
[AGENT][NEUTRAL] And the reason for the denial is that we need the primary insurance company's explanation of benefits.
[CUSTOMER][NEUTRAL] Mm, OK.
[CUSTOMER][NEUTRAL] I confirming.
[CUSTOMER][NEUTRAL] EUB, OK.
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] And if you need a copy of this explanation of benefits, [PII], you may print that by going to our portal at [PII].
[CUSTOMER][NEUTRAL] Really
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] And may I know, uh, just a moment.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] 56798. OK. And may I know the call reference number here?
[AGENT][NEUTRAL] My name and today's date.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. And is there anything else I can help you with?
[CUSTOMER][POSITIVE] Um, you know, OK. No problem.
[CUSTOMER][POSITIVE] Thank you so much for asking. That's it.
[AGENT][POSITIVE] Well, you're welcome. OK, [PII]. Well then, if that's all I can help you with, and thank you again for calling APL and I hope you have a very nice day.
[CUSTOMER][NEUTRAL] You too. Bye-bye.
[AGENT][POSITIVE] Thank you. Uh-huh. Bye bye.