AccountId: 011433970860
ContactId: f780d88e-d3d3-4cf8-be1c-1ef6b0bf4c46
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 223360 ms
Total Talk Time (AGENT): 115034 ms
Total Talk Time (CUSTOMER): 93993 ms
Interruptions: 0
Overall Sentiment: AGENT=1.5, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/27/f780d88e-d3d3-4cf8-be1c-1ef6b0bf4c46_20250227T15:51_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi [PII], um, I am receiving an invoice from my from my doctor. Uh, I called them, they said that APL denied the claim, but I wanted to confirm that you guys actually have record of them sending in the claim.
[AGENT][POSITIVE] OK, sure. I can assist you. And may I have your name and a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Yes, my name is [PII]. Uh phone number is [PII].
[AGENT][NEUTRAL] Thank you and may I have the policy number, Miss [PII]?
[CUSTOMER][NEUTRAL] Yes, it is 2483217 and it's under my husband who's the primary.
[AGENT][NEUTRAL] OK. And the claim is for yourself or for your husband?
[CUSTOMER][NEUTRAL] Yes, for me.
[AGENT][NEUTRAL] Just for yourself, OK. All right. um, may I have your date of birth for security?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And may I have the mailing address on file for verification?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, thank you. And what is the date of service, Ms. [PII]?
[CUSTOMER][NEUTRAL] I have multiple on this invoice. I have [PII].
[CUSTOMER][NEUTRAL] Uh, [PII], and [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And it just kind of I'm thinking they maybe are just not sending it to you guys and telling me that it's being denied, but I wanna confirm before I call them.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] The one for [PII], how much was it for?
[CUSTOMER][NEUTRAL] A
[CUSTOMER][NEUTRAL] $2,246.03.
[AGENT][NEUTRAL] What's the name of the facility or provider that is charging you the bill?
[CUSTOMER][NEUTRAL] Advanced female care.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh let me check the [PII].
[AGENT][NEUTRAL] Hm, OK, so the ones for um for [PII], um,
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Because this policy started on [PII]. Let me go ahead and start off with that one first, OK? Um, so basically the only one we have received for that date of service is the one from [PII]. um, and we already paid the one for Sheridan. Um, if it's not from [PII], then, um, they have not sent in the claim. There's no claims on file other than this one. no. And.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] They have not sent in the claim.
[CUSTOMER][POSITIVE] OK, perfect. Alright, let me give them a call now um and if not I can always get the EOB and file it directly with you guys, right?
[AGENT][NEUTRAL] Correct, yes. You need to get the itemized bill with the diagnosis code. You need the copy of the explanation of benefits from the primary insurance, and you need uh the claim form. The claim form is in our website at a go ahead. OK. Go ahead.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] It's like I, yes.
[CUSTOMER][POSITIVE] OK, perfect. And what was your name?
[AGENT][NEUTRAL] My name is [PII].
[CUSTOMER][POSITIVE] Thank you, sir. Have a great day.
[AGENT][POSITIVE] You're welcome. Is there anything else I may help you with today?
[CUSTOMER][NEUTRAL] No, that's it for right now.
[AGENT][POSITIVE] OK. Thank you for calling APL. Have a good day and thank you for calling.
[CUSTOMER][POSITIVE] You too thanks bye bye.
[AGENT][POSITIVE] You're welcome bye bye