AccountId: 011433970860
ContactId: 01a7c977-a135-424f-a1bb-ab4d170189e7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 261649 ms
Total Talk Time (AGENT): 58182 ms
Total Talk Time (CUSTOMER): 81967 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/23/01a7c977-a135-424f-a1bb-ab4d170189e7_20250623T18:45_UTC.wav
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[AGENT][NEUTRAL] Calling APL, my name is [PII]. How can I assist you today?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII] calling from [PII]'s office to check on a claim.
[AGENT][POSITIVE] I'd be happy to assist with claim status today, [PII], if I can get a good call back number for you.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And what is the policy number?
[CUSTOMER][NEUTRAL] Just 1 2nd.
[CUSTOMER][NEUTRAL] One moment, I'm looking for that.
[CUSTOMER][NEUTRAL] You're asking for the member ID, right?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] Yeah, [PII], before we could start, could you please spell your name for me with your initial?
[AGENT][NEUTRAL] [PII], last initial is [PII].
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] The member ID is gonna be
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] 02462881.
[AGENT][NEUTRAL] Patient's name and date of birth.
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] And the date of service for the claim?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] That's the date of service?
[CUSTOMER][NEUTRAL] Uh, [PII] $184 even.
[AGENT][NEUTRAL] Thank you for that information. I'm showing the claim was denied because office visits are not covered under the policy.
[CUSTOMER][NEUTRAL] So member is liable for the bill amount?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] Office visits are not covered. Could you repeat that?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] are not covered under the patients, according to patient's plan.
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] May I know the member is liable for how many dollars?
[AGENT][NEUTRAL] Uh, well, we don't determine patient responsibility, but um, I would assume the whole thing since we're not paying anything.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] One moment.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, can I have the call reference number?
[AGENT][NEUTRAL] Reference is just my name [PII] last initial [PII], and the date and time of the call. Was there anything else I could assist with today?
[CUSTOMER][NEUTRAL] I have a few more dates of service for the same member.
[AGENT][NEUTRAL] What's the date of service?
[CUSTOMER][NEUTRAL] One moment.
[CUSTOMER][NEGATIVE] Because I need to close one tab and open the other tab. That's a big frustration I'm having. One sec.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][POSITIVE] One moment, I'm so sorry.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, [PII]. The next date of service, [PII].
[CUSTOMER][NEUTRAL] For $129 even.
[AGENT][NEUTRAL] OK, um, same denial office visits are not covered under the policy.
[CUSTOMER][NEUTRAL] OK, could you send me the EOB?
[AGENT][NEUTRAL] OK, what is the fax number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Alright, you should receive that fax within 15 to 20 minutes.
[CUSTOMER][POSITIVE] OK, thank you, thank you so much. Bye bye.
[AGENT][POSITIVE] OK, thank you for calling APO you have a good day.