AccountId: 011433970860
ContactId: fa049e35-716a-4e5d-8be8-d58d3961e1fd
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 190380 ms
Total Talk Time (AGENT): 83701 ms
Total Talk Time (CUSTOMER): 50071 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/23/fa049e35-716a-4e5d-8be8-d58d3961e1fd_20250623T15:48_UTC.wav
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[AGENT][POSITIVE] Thank you for calling A. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], I needed to check the status on a claim.
[AGENT][NEUTRAL] OK, I can help you with claim status. Do you have a good callback number and your name?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Excuse me, [PII]. My name is [PII].
[AGENT][NEUTRAL] OK, [PII], and you're with the provider's office, is that right?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. And do you have the policy number for that patient?
[CUSTOMER][NEUTRAL] Uh, let me see, policy is 02622233115.
[AGENT][NEUTRAL] And the patient name and date of birth?
[CUSTOMER][NEUTRAL] It's under [PII] [PII].
[AGENT][NEUTRAL] And what was the date of service and bill charges?
[CUSTOMER][NEUTRAL] Data service is 469 and it's 50101.
[AGENT][NEUTRAL] Uh, it looks like we received the claim on
[AGENT][NEUTRAL] [PII]. That was processed [PII].
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] Uh, looks like we're waiting on eligibility from the employer, so once that's received, we can continue processing the claim.
[CUSTOMER][NEUTRAL] OK, so we just have the thing is that I got an EOB that's why I was calling.
[AGENT][NEUTRAL] Right, did it have a
[CUSTOMER][NEUTRAL] And it says uh total patients responses.
[AGENT][NEUTRAL] Um, so we're, so it's, it's kind of in a denied state because we haven't received, we received weekly eligibility files from the employer, sometimes they can be a few weeks behind, so right now we haven't received anything recent, so it's just.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] It's in a denied state, but it could be processed once we receive that eligibility.
[CUSTOMER][NEUTRAL] OK. So usually, how long does it take?
[AGENT][NEUTRAL] Um, usually it just takes a few weeks, sometimes up to a couple of weeks. Um, the last we've got a pay to date of [PII], so.
[AGENT][NEUTRAL] And the state of service was [PII].
[AGENT][NEUTRAL] So, I'd probably allow maybe another 5 to 7 working days. If we don't have it by then, it probably will remain denied.
[CUSTOMER][NEUTRAL] OK, alrighty, well, let me go, uh, I guess I'll call you back next week.
[AGENT][NEUTRAL] OK. Anything else I can help with today?
[CUSTOMER][NEUTRAL] No, can I go ahead and have a reference number?
[AGENT][NEUTRAL] Yes, reference number is my name is [PII]. First initial to last name [PII], and today's date.
[CUSTOMER][POSITIVE] Thank you very much. Have a good day.
[AGENT][POSITIVE] Thanks for calling. You too, bye bye.