AccountId: 011433970860
ContactId: 04e8970c-d65b-4e97-a894-404386bb010c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 588900 ms
Total Talk Time (AGENT): 126643 ms
Total Talk Time (CUSTOMER): 139558 ms
Interruptions: 1
Overall Sentiment: AGENT=1.3, CUSTOMER=-0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/21/04e8970c-d65b-4e97-a894-404386bb010c_20250321T16:43_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, um, [PII], good afternoon. This is [PII] calling from Sleep Disorder Center of Louisiana, and I would like to check the status of our claim, please.
[AGENT][NEUTRAL] OK, Miss [PII], I can help you with the claim status. Can I please get your call back number?
[CUSTOMER][NEUTRAL] Yes, it is [PII] I'm sorry, [PII], the extension.
[AGENT][NEUTRAL] Thank you ma'am and then what's the patient's name, date of birth and policy number?
[CUSTOMER][NEUTRAL] Yes, policy number, it is 01633180. And this is for [PII]. Date of birth [PII].
[AGENT][POSITIVE] OK, thank you so much and let me look that up real quick.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK and then what is the data service and the charge amount?
[CUSTOMER][NEUTRAL] Yes, uh, [PII]. The charge amount is $712.86.
[AGENT][NEUTRAL] OK, let me look that.
[AGENT][NEUTRAL] And then, and you said you're with the Sleep Disorder Center of Louisiana, is that correct?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes, uh, or it's under the billing provider, uh, [PII].
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] OK, thank you so much. I'm going to put you on a brief hold while I look up this claim for us and I will be right back. Thank you, ma'am.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Ms. [PII], thank you so much for holding for me. I have the claim pulled up. The claim number is 3561516.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And let's see what it says.
[AGENT][NEUTRAL] I'm sorry, let me pull it up again. I just lost it, but I'm getting it back. OK, so the claim was denied um and I'm sorry, let me give you the new the 3561516 was a duplicate claim. The claim number is 3561507.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And the claim was denied as non-covered, durable medical equipment is not covered under this policy.
[CUSTOMER][NEUTRAL] OK, not covered.
[CUSTOMER][NEUTRAL] Her [PII].
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. Uh, let me just check something here. So, uh, can you please check this another, uh, dates of service for this member? Just wanna make sure that it was also denied.
[AGENT][NEUTRAL] OK, yes ma'am, I can do that. What is the date of service?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Yes, uh, [PII], billed amount is $793.62.
[AGENT][NEUTRAL] OK, let me look that up real quick.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, ma'am. The claim number is 356.
[AGENT][NEUTRAL] 1503 and it was denied for the same reason.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] OK, and uh I have uh last date of service.
[CUSTOMER][NEUTRAL] The data service, um.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And the bill amount it's $41.31.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, let me look up that one real quick.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're very welcome.
[AGENT][NEUTRAL] And that one was um claim number 356.
[AGENT][NEUTRAL] 1506 and it was denied for the same reason.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK. All right, thank you so much. Do you provide call reference number?
[AGENT][NEUTRAL] Yes, ma'am. You can use my name, [PII] and today's date.
[CUSTOMER][POSITIVE] Mhm. OK. All right. That's all for today. Thank you for your time and help. You have a great day. Bye for now.
[AGENT][POSITIVE] You're very welcome. You too, Ms. [PII]. Have a good weekend and thanks [PII] bye bye ma'am.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] You too. Bye.