AccountId: 011433970860
ContactId: 0681241b-15ba-438b-9a13-8e26b1519f12
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 309739 ms
Total Talk Time (AGENT): 77768 ms
Total Talk Time (CUSTOMER): 84594 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/08/0681241b-15ba-438b-9a13-8e26b1519f12_20250408T16:55_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII]. And I'm calling for a provider to check on additional information about the claim that has been denied. Please note this call will be monitored and recorded for quality and training purposes. Good afternoon, [PII]. How are you doing today?
[AGENT][POSITIVE] I'm doing good, [PII]. How are you doing today?
[CUSTOMER][POSITIVE] Doing fine, thanks for asking.
[AGENT][NEUTRAL] Uh, can I please get your callback number, [PII], just in case our call is disconnected?
[CUSTOMER][NEUTRAL] Yes, the callback number is [PII]. It's a direct line.
[AGENT][NEUTRAL] Thank you, sir. And then what is the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] The patient is
[CUSTOMER][NEUTRAL] I'll start with the policy number which is 01631918.
[CUSTOMER][NEUTRAL] And patient is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK, let me look up that policy real quick.
[AGENT][NEUTRAL] Alright, and then can you please give me the date of service and the charge amount?
[CUSTOMER][NEUTRAL] Yes, the data service was on [PII]. The total charge on one quick moment.
[CUSTOMER][NEUTRAL] Total charge amount is $345 even.
[AGENT][NEUTRAL] Thank you. And then the, I got [PII]. What was the actual day?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] OK thank you and the the um charge amount after the primary insurance paid their part?
[CUSTOMER][NEUTRAL] After the insurance, it is $40 even.
[AGENT][NEUTRAL] OK. And can you please give me the name of the facility you're calling from?
[CUSTOMER][NEUTRAL] Yes, the facility name is Carolina Orthopedic and Neurosurgical Associates.
[AGENT][NEUTRAL] OK, I'm gonna put you on a brief hold, [PII], while I look up this claim for us and I'll be right back.
[CUSTOMER][POSITIVE] Yes, take your time.
[AGENT][POSITIVE] Thank you, sir.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Hello.
[AGENT][NEUTRAL] Hello, I've got the claim for you. The claim number is 357-598-0. The claim was denied for non-covered, uh, kinesiology, speech, or occupational therapy are not covered benefits under the patient's policy.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Uh yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Got it. Thank you very much for that information. And may I know the plan type of this patient?
[AGENT][NEUTRAL] Yes, it's Medlink.
[CUSTOMER][NEUTRAL] Medlink. All right, got it. And could you please provide me a call reference number for our call?
[AGENT][NEUTRAL] Yes sir, you can use my name [PII].
[AGENT][NEUTRAL] [PII] and the date.
[CUSTOMER][POSITIVE] Got it, [PII]. Then that would be all. Thank you so much for your assistance. Have a great day and take care. Bye for now.
[AGENT][POSITIVE] You too [PII] you have a good day also and thank you for calling APL bye bye sir.
[CUSTOMER][POSITIVE] You're welcome. Bye