AccountId: 011433970860
ContactId: f37d36a6-48ec-4601-9f67-c26318ada600
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 584869 ms
Total Talk Time (AGENT): 112865 ms
Total Talk Time (CUSTOMER): 94521 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=-1.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/06/f37d36a6-48ec-4601-9f67-c26318ada600_20250306T18:43_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is. How may I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII] and I'm calling from the doctor's office looking for the claim status.
[AGENT][NEUTRAL] OK, [PII], I can help you with the claim status, sir, and can you please give me your callback number just in case our call is disconnected.
[CUSTOMER][NEUTRAL] Yes, my callback number is [PII].
[AGENT][NEUTRAL] Thank you and then what is the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Yeah, the policy number is 023.
[CUSTOMER][NEUTRAL] 99312.
[CUSTOMER][NEUTRAL] And the patient name is [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] OK, let me pull up that policy number real quick.
[AGENT][NEUTRAL] OK thank you and what is the data service for the claim?
[CUSTOMER][NEUTRAL] The date of services for [PII] with the amount of $174.60.
[AGENT][NEUTRAL] OK, and then what is the um amount after the primary insurance paid their part?
[CUSTOMER][NEUTRAL] Uh, as per my system, American Public Life is acting as primary.
[AGENT][NEUTRAL] OK and then what is the name of the facility that you're calling from?
[AGENT][NEUTRAL] Sir.
[CUSTOMER][NEUTRAL] I'm calling from Dermatology Associates.
[AGENT][POSITIVE] OK, thank you so much, [PII]. I'm gonna put you on a brief hold while I look this claim up for you and I'll be right back sir.
[CUSTOMER][POSITIVE] Sure, take your time.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Thank you for holding for me, [PII]. I did find the claim. The claim number is 3,553,290.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And the claim has been denied because we need the primary insurance EOB, the EOB copy from the primary insurance carrier.
[CUSTOMER][NEUTRAL] OK. OK.
[CUSTOMER][NEUTRAL] Can I get the claim received date and the denied date, please?
[AGENT][NEUTRAL] Yes, sir.
[AGENT][NEUTRAL] We received the claim on [PII] and we processed the claim on [PII].
[CUSTOMER][NEUTRAL] Uh, may I know which insurance is acting as primary? Do you have the information handy?
[AGENT][NEUTRAL] I don't have that information.
[CUSTOMER][NEUTRAL] OK. And I just want to confirm the claim number which is 353,290, right?
[AGENT][NEUTRAL] 3,553,290
[CUSTOMER][NEUTRAL] OK, got it.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Can I get a copy of your with through fax?
[AGENT][NEUTRAL] Yes, you can. Can you give me your fax number please?
[CUSTOMER][NEUTRAL] Yes, the fax number is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, I'm on a brief hold, sir while I um send that fax to you I'll be right back.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][POSITIVE] Thank you, sir.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you so much for holding for me [PII]. I've got that fax on its way to you now sir.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. Uh, can I get the COP updated date?
[AGENT][NEUTRAL] I'm sorry, what did you ask for?
[CUSTOMER][NEUTRAL] Uh, may I know the coordination of benefit updated date by the member?
[AGENT][NEUTRAL] We, we don't do coordination of benefits.
[CUSTOMER][NEUTRAL] Oh, OK. And the reference number for this call, please?
[AGENT][NEUTRAL] Yes sir, you can use my name [PII] and today's date.
[CUSTOMER][POSITIVE] Got it. That's perfect. And thank you so much for helping with this claim. Have a wonderful day.
[AGENT][NEUTRAL] You too, [PII]. um is there anything I can help you with sir before we go?
[CUSTOMER][NEGATIVE] No, thanks, bye.
[AGENT][POSITIVE] You're welcome. You have a great day and thanks for calling APL. Bye bye sir.