AccountId: 011433970860
ContactId: 03f5948b-009e-4eca-8dce-5664752a60e6
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 199110 ms
Total Talk Time (AGENT): 63882 ms
Total Talk Time (CUSTOMER): 71170 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2024/12/30/03f5948b-009e-4eca-8dce-5664752a60e6_20241230T15:59_UTC.wav
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[AGENT][POSITIVE] Thank you for calling American Public Life. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from provider's office to check the claim status.
[AGENT][NEUTRAL] OK, [PII], I can help you with that. Could I get a callback number?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Thank you. And what is the policy number you're calling on?
[CUSTOMER][NEUTRAL] Yeah, it's uh one moment please.
[CUSTOMER][NEUTRAL] One moment please, I'm checking you.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] The policy, I have a claim number. Uh OK, I have a policy number. It's 02440270.
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] Patient's name, [PII].
[AGENT][NEUTRAL] And date of birth.
[CUSTOMER][NEUTRAL] One moment, please.
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] Date of birth, [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And you did say you're calling for status today. What is the date of service?
[CUSTOMER][NEUTRAL] It's uh [PII].
[AGENT][NEUTRAL] Total bill
[CUSTOMER][NEUTRAL] $1,042 even.
[AGENT][POSITIVE] OK, thank you so much for verifying the account.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I'm sorry, uh, for that data service, let's see.
[AGENT][NEUTRAL] OK, I show the claim was received and denied. Uh, this policy does not cover services rendered at the doctor's office. Is there anything else I can help you with?
[CUSTOMER][NEUTRAL] May I know the co-pay amount?
[AGENT][NEUTRAL] This policy does not cover services rendered at the doctor's office. The claim was denied.
[CUSTOMER][POSITIVE] Good afternoon.
[CUSTOMER][NEUTRAL] OK. Can I get the co-pay amount for this?
[AGENT][NEUTRAL] Ma'am, there is no co-pay amount.
[AGENT][NEUTRAL] We did not consider the charges. You would need to contact the primary. We are secondary, uh, for co-pay amount, you would need to contact the primary insurance.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK. My primary insurance have a PPO plan. Uh,
[AGENT][NEUTRAL] This is a supplemental gap policy.
[CUSTOMER][NEUTRAL] And uh
[CUSTOMER][NEUTRAL] OK.