AccountId: 011433970860
ContactId: e3f0f068-d80c-4137-b830-78e0e2302516
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 224380 ms
Total Talk Time (AGENT): 63692 ms
Total Talk Time (CUSTOMER): 86358 ms
Interruptions: 1
Overall Sentiment: AGENT=0, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/10/e3f0f068-d80c-4137-b830-78e0e2302516_20250210T13:01_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling UP Health. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] and my last name is [PII], calling from Valley Regional Medical Center to check on the denial of the claim.
[AGENT][NEUTRAL] OK, Ma, I can help you. What's the policy number?
[CUSTOMER][NEUTRAL] Uh, it is 1514651.
[AGENT][NEUTRAL] And what's the claim number?
[CUSTOMER][NEUTRAL] 344-2350
[AGENT][NEUTRAL] And what's a good callback number in case we're dis disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you, you can verify the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yes, patient name is [PII].
[CUSTOMER][NEUTRAL] And last name is. OK, first name is [PII] and last name is [PII]
[AGENT][NEUTRAL] And just the date of birth. Just the date of birth.
[CUSTOMER][NEUTRAL] And date of
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and you said that you were calling on clarification of the denial?
[CUSTOMER][NEUTRAL] Actually, they stated that uh they need the documents uh in order to reprocess the claim. I don't know which documents and all that is.
[AGENT][NEUTRAL] What's the date of service of the claim?
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] OK, so the correct, do you have a copy of the ELB in your hand?
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] A copy of the major medical explanation of benefits is what's needed.
[CUSTOMER][NEUTRAL] Uh, I need information. Uh, if you want to send the UB, you can send me.
[AGENT][NEUTRAL] No, we're requesting a copy of the major medical explanation of benefits to complete our claim processing.
[CUSTOMER][NEUTRAL] OK. You need EUB, right? Primary EUB.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Previously, it was sent. Could you please check with that?
[AGENT][NEGATIVE] We didn't receive it.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Can I get the fax number or mailing address, uh, in order to your priority?
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] The fax number is 877.
[CUSTOMER][NEUTRAL] To receive this.
[AGENT][NEUTRAL] 365.
[AGENT][NEUTRAL] 942 3.
[CUSTOMER][NEUTRAL] OK, may I get the claim receive date?
[AGENT][NEUTRAL] It was received [PII], processed on [PII].
[CUSTOMER][POSITIVE] OK, thank you so much.
[AGENT][NEUTRAL] Anything else?
[CUSTOMER][NEUTRAL] Can I get the call reference?
[AGENT][NEUTRAL] My name in today's date, [PII], first initial and last name is [PII].
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] All right, if any other, no other, no other questions, [PII], thank you for calling APL. Have a good day.
[CUSTOMER][POSITIVE] Have a great day.
[CUSTOMER][NEUTRAL] You too. Bye.