AccountId: 011433970860
ContactId: f549930a-2e09-4745-8a7a-dc1a195f86d4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 285839 ms
Total Talk Time (AGENT): 111425 ms
Total Talk Time (CUSTOMER): 74563 ms
Interruptions: 1
Overall Sentiment: AGENT=0.4, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/16/f549930a-2e09-4745-8a7a-dc1a195f86d4_20250516T20:21_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] My name is [PII] and I'm calling from the provider's office for the denied the claim status.
[AGENT][NEUTRAL] OK [PII], you have a claim that you're wanting to find out the reason for the denial on, is that correct?
[CUSTOMER][NEUTRAL] Uh no. Uh, yeah, uh, I, I think I do have the reason. I needed the uh uh I mean, additional information.
[AGENT][NEUTRAL] OK, you need additional information on a claim that was denied, is that correct?
[CUSTOMER][NEUTRAL] Yes, yes.
[AGENT][NEUTRAL] Yes, [PII], I can help you. And what is your callback number?
[CUSTOMER][NEUTRAL] [PII] direct line.
[AGENT][NEUTRAL] Thank you and the member's policy number?
[CUSTOMER][NEUTRAL] Mm, give me a moment. That's 02587342 Mike Lima number 8.
[AGENT][NEUTRAL] Thank you, one moment please while I get the member's information pulled up.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And any information provided would be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Just a moment.
[CUSTOMER][NEUTRAL] It is [PII] and the date of birth is [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] What is the date of service and total bill amount, please?
[CUSTOMER][NEUTRAL] [PII], and the bill amount is $993 even.
[AGENT][NEUTRAL] And the claim number?
[CUSTOMER][NEUTRAL] 3581041.
[AGENT][NEUTRAL] One moment, please.
[AGENT][NEUTRAL] OK, yes sir, so how can I help you with this claim today?
[CUSTOMER][NEUTRAL] And this claim is denied for the primary UB. So may I know which is the primary insurance for this member?
[AGENT][NEUTRAL] According to our records, sir.
[AGENT][NEUTRAL] For the employer that give me one moment for her husband's employer we show that to the.
[CUSTOMER][NEUTRAL] This
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] And what's the member ID for that?
[AGENT][NEUTRAL] I don't have that. You would have to contact the employee to get that information.
[CUSTOMER][NEUTRAL] OK. And when was this claim denied?
[AGENT][NEUTRAL] The denial date was [PII].
[CUSTOMER][NEUTRAL] The call reference number?
[AGENT][NEUTRAL] My name in today's date and if you need a copy of that EOV you can print it from our portal at [PII].
[AGENT][NEUTRAL] Is there anything else, [PII], I can help you with?
[CUSTOMER][POSITIVE] Thank you. Just a moment.
[CUSTOMER][NEUTRAL] Mm, just I'm checking if there are any other claims that we can look after or.
[CUSTOMER][NEUTRAL] And yeah, there are 3 more claims.
[AGENT][NEUTRAL] OK, so again, I can help you with them. Are they for different patients or the same number?
[CUSTOMER][NEUTRAL] Different patient.
[AGENT][NEUTRAL] OK, so you would use my name and today's date as all of your call reference numbers. Any information that I provide on any claim will be a verification of benefits and not a guarantee of payment. And if you need a copy of any of the explanation of benefits, you can print that by going to that portal at [PII].
[CUSTOMER][POSITIVE] OK. Oh, sorry, but I don't, I think, oh no, there are no more claims. Thank you so much for your assistance, sir.
[AGENT][NEUTRAL] Yes, so you would have to register. OK.
[AGENT][NEUTRAL] So there are no more claims?
[CUSTOMER][POSITIVE] Yes. Thank you.
[CUSTOMER][NEUTRAL] No.
[AGENT][POSITIVE] OK, well then, thank you again for calling APL and I hope you have a nice weekend.
[CUSTOMER][NEUTRAL] Bye bye.
[CUSTOMER][NEUTRAL] Yes.