AccountId: 011433970860
ContactId: e4697a76-a53c-4812-9847-acffc06efdd9
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 231020 ms
Total Talk Time (AGENT): 105349 ms
Total Talk Time (CUSTOMER): 61449 ms
Interruptions: 1
Overall Sentiment: AGENT=1.2, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/09/e4697a76-a53c-4812-9847-acffc06efdd9_20250509T14:37_UTC.wav
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[AGENT][NEUTRAL] And thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hello, hi. This is [PII] here, and I'm calling from provider's office to check the claim status. How are you doing today?
[AGENT][POSITIVE] OK, did you, I'm good, [PII], thank you. How are you today?
[CUSTOMER][POSITIVE] I'm doing good, thank you, thank you for asking.
[AGENT][NEUTRAL] Good, so you're needing claim status, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Yes ma'am, I can help you with that. And what is your callback number, please?
[CUSTOMER][NEUTRAL] [PII]. And this is your direct line.
[AGENT][NEUTRAL] Thank you. And how many claimsa do you have to check status on?
[CUSTOMER][NEUTRAL] Only one claim.
[AGENT][NEUTRAL] OK. And what is that member's policy number?
[CUSTOMER][NEUTRAL] Yeah, sure. Let me provide you that.
[CUSTOMER][NEUTRAL] 02493493, M as in Maria, L as in Lima, number 8.
[AGENT][NEUTRAL] OK thank you one moment while I get the member's information pulled up please.
[AGENT][NEUTRAL] And any information that I do provide for you, [PII] will be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Patient name is uh
[CUSTOMER][NEUTRAL] One moment. [PII]. Uh date of birth, [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And what is the date of service and total bill amount for her?
[CUSTOMER][NEUTRAL] Yeah, date of service that is [PII]. Total charges $747.05.
[AGENT][POSITIVE] Thank you. One moment.
[AGENT][NEUTRAL] OK, so, so this was received, the received date on the claim was 5-6-2025. It was processed and denied on [PII].
[AGENT][NEUTRAL] The claim number is 359919-6.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And the reason for the denial on this claim states, please provide copies of your explanation of benefits from your primary insurance carrier.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] We need a copy of the primary insurance.
[CUSTOMER][NEUTRAL] OK. Could you please spell out?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Sure, sure. Could you please spell out your name for me?
[AGENT][NEUTRAL] My name is [PII] My name in today's date will be your call reference number. And if you need a copy of this TRA.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] And if you need a copy of this explanation of benefits, you can print that by using that claim number from our website at [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Got it, got it. Thank you so much, [PII]. Have a nice day. Bye-bye.
[AGENT][POSITIVE] OK, well, you're welcome. Yes ma'am. Well, if that's all I can help you with, thank you again for calling APL and I hope you have a nice day also.
[CUSTOMER][NEUTRAL] Mhm.