AccountId: 011433970860
ContactId: 0057f9cc-e7b5-4587-b7c3-224af3cfaf29
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 182070 ms
Total Talk Time (AGENT): 75390 ms
Total Talk Time (CUSTOMER): 69809 ms
Interruptions: 1
Overall Sentiment: AGENT=0.2, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/28/0057f9cc-e7b5-4587-b7c3-224af3cfaf29_20250328T14:09_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes, I have a secondary claim um that denied for non-covered services, and I just need a little bit of clarification on that since it is a secondary payment.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Of course, yeah, I can take a look at that claim for you. We get some clarification on that. uh, what was your name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Was this for your individual policy [PII]?
[CUSTOMER][NEUTRAL] No, I'm calling from the provider's office.
[AGENT][NEUTRAL] Gotcha. OK.
[AGENT][NEUTRAL] And then, uh, can I get a good call back number from you [PII] in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes, it is 469.
[CUSTOMER][NEUTRAL] Uh yep, [PII].
[AGENT][NEUTRAL] Thank you. Do you have that policy number?
[CUSTOMER][NEUTRAL] Um, I do. Give me just a second.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Maybe I don't let's see.
[AGENT][NEUTRAL] Um, it's OK. Do you have the claim number by chance?
[CUSTOMER][NEUTRAL] Let me go into the patient's insurance.
[CUSTOMER][NEUTRAL] I do. I have that EOB pulled up right now. So.
[AGENT][NEUTRAL] OK, I can use that. I can use that card number, that's fine.
[CUSTOMER][NEUTRAL] Hi
[CUSTOMER][NEUTRAL] OK, it's 349-331-9.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK thank you one moment.
[AGENT][NEUTRAL] OK, and then, uh, what was the name and date of birth for the patient please?
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] And her date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you for verifying that. All right, one moment. Let me take a look at this.
[AGENT][NEUTRAL] OK. So yes, this is a secondary medical policy. On this policy, it does not offer any coverage for office visits or treatment received in a physician's office or clinic.
[CUSTOMER][NEUTRAL] OK, so that would then be patient's responsibility, correct?
[AGENT][NEUTRAL] Uh, we don't say what is patient responsibility that would be up to the provider.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, well, I just wanna make sure it's not like a Medicaid plan or something like that where we cannot build the patient, um.
[AGENT][NEUTRAL] Of course.
[AGENT][NEUTRAL] Right, no, no, we just don't say one way or the other.
[CUSTOMER][POSITIVE] I got you I got you. OK, well thank you so much for your help today you have a wonderful day.
[AGENT][NEUTRAL] Of course.
[AGENT][NEUTRAL] Yeah, was there anything else I could help you with, [PII]?
[CUSTOMER][NEUTRAL] No, that'll be it. Is there a reference number for this call?
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] It would just be my first name, last initial, and today's date. Uh, so my name is spelled [PII]
[CUSTOMER][NEUTRAL] And today's date
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] OK perfect thank you so much for your help you have a wonderful day.
[AGENT][POSITIVE] Alright, of course. Thanks for calling APL. You too. Bye bye.
[CUSTOMER][NEUTRAL] Yes, I did that.