AccountId: 011433970860
ContactId: 00f56e73-5eb0-4128-8871-39b17de5204c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 130419 ms
Total Talk Time (AGENT): 59448 ms
Total Talk Time (CUSTOMER): 59029 ms
Interruptions: 1
Overall Sentiment: AGENT=3.1, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/22/00f56e73-5eb0-4128-8871-39b17de5204c_20250522T15:38_UTC.wav
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[AGENT][POSITIVE] Morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Hi, this is, this is [PII] calling from Primary Care PC. I'm just calling regarding explanation of benefits I received for a patient.
[AGENT][POSITIVE] What would be my pleasure to assist you, and I didn't understand your name. What is your name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] [PII], thank you. And a good callback number, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And do you have that claim number so I can get that EOP pulled up?
[CUSTOMER][NEUTRAL] Um, yeah, it is 360-1194.
[AGENT][NEUTRAL] Thank you, [PII]. What is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] And then finally, what is that total bill amount?
[CUSTOMER][NEUTRAL] $370.
[AGENT][NEUTRAL] OK, for primary care. And it was denied as office visits are not covered under the patient's plan?
[CUSTOMER][NEUTRAL] OK, that's all I needed was a reason for the denial.
[AGENT][NEUTRAL] Yeah, if you have that AOB on page 2, it does describe the denial reason.
[CUSTOMER][NEUTRAL] Um, well, the other way it's scanned and it's awfully blurry to be honest, so, um, I don't have the paper so now this is just a.
[AGENT][POSITIVE] I got you.
[AGENT][NEUTRAL] Yeah, and sometimes they always stay on one side.
[CUSTOMER][NEUTRAL] Yeah, exactly, so this is just the copay, so you guys don't cover the copay, um, because this is the secondary insurance, you guys don't cover the copay for the office visit.
[AGENT][NEUTRAL] Mhm
[AGENT][POSITIVE] That's right.
[AGENT][POSITIVE] That is correct. Mhm.
[CUSTOMER][NEUTRAL] OK, just double checking to make sure. All right, great. All right, can I get a reference number?
[AGENT][NEUTRAL] Sure, it's my name and today's date, and I spell my name [PII].
[AGENT][POSITIVE] [PII], it was a pleasure to assist you with that claim information. I hope you have a wonderful day.
[CUSTOMER][POSITIVE] Thank you you too bye bye.
[AGENT][POSITIVE] Thank you for calling APO.