AccountId: 011433970860
ContactId: 0853737f-de39-48ac-be82-271a691cad88
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 393399 ms
Total Talk Time (AGENT): 73780 ms
Total Talk Time (CUSTOMER): 95274 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/02/0853737f-de39-48ac-be82-271a691cad88_20250502T13:49_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yeah, hi, my name is [PII] calling my office to check on claims status.
[AGENT][NEUTRAL] OK, [PII], I can help you with claims. So do you have a good callback number?
[CUSTOMER][NEUTRAL] [PII]. It's a direct line.
[AGENT][NEUTRAL] And the policy number of the patient?
[CUSTOMER][NEUTRAL] 02389384.
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And the date of birth is [PII].
[AGENT][NEUTRAL] And date of service and bill charges?
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEGATIVE] And the total charge is $179 even.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, looks like we received that on 8-16-2024.
[AGENT][NEUTRAL] Process 820 2024.
[AGENT][NEUTRAL] And then office visits are not covered under the policy.
[CUSTOMER][NEUTRAL] OK, another plan type?
[AGENT][NEUTRAL] The what?
[CUSTOMER][NEUTRAL] So what's
[CUSTOMER][NEUTRAL] And another patient plan type?
[AGENT][NEUTRAL] Plan type, it's a secondary policy.
[CUSTOMER][NEUTRAL] Another plan name?
[AGENT][NEUTRAL] Medli 6.
[CUSTOMER][NEUTRAL] 6
[CUSTOMER][NEUTRAL] It's may know plan des PPO or HMO?
[AGENT][NEUTRAL] It's neither, it's a secondary plan.
[CUSTOMER][NEUTRAL] Plan.
[CUSTOMER][NEUTRAL] Uh, may I know the plan name?
[AGENT][NEUTRAL] Medlink 6.
[CUSTOMER][NEUTRAL] 6
[CUSTOMER][NEUTRAL] Meddling 6, right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK. So we need to appeal for this claim.
[AGENT][NEUTRAL] I mean it's a secondary policy, so office visits aren't covered, so it's just not covered under the policy.
[CUSTOMER][NEUTRAL] And
[AGENT][NEUTRAL] I mean you can send in an appeal, but we would be denied.
[CUSTOMER][NEUTRAL] OK, on more money.
[CUSTOMER][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] May I know the call number?
[AGENT][NEUTRAL] The what?
[CUSTOMER][NEUTRAL] What
[CUSTOMER][NEUTRAL] And another call reference number?
[AGENT][NEUTRAL] All reference number is my name, [PII], and today's state.
[CUSTOMER][NEUTRAL] My name is [PII].
[CUSTOMER][NEUTRAL] OK, and could you based upon the next claim?
[AGENT][NEUTRAL] Hold on a moment.
[AGENT][NEUTRAL] For the same patient?
[CUSTOMER][NEUTRAL] The same patient. Yeah.
[CUSTOMER][NEUTRAL] The date of service is [PII].
[CUSTOMER][NEUTRAL] The total charge is $277 even.
[AGENT][NEUTRAL] OK, you said 104-2004 or [PII]?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] That was received 42-2025, process 44-2025.
[CUSTOMER][NEUTRAL] 2
[AGENT][NEUTRAL] Denied office visits not covered or policy.
[CUSTOMER][NEUTRAL] 25.
[CUSTOMER][NEUTRAL] Of not covered your policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, could you please send a copy of your withdrawal fax number? And could you please tell me the claim number also?
[AGENT][NEUTRAL] My number is 358-531-5.
[CUSTOMER][NEUTRAL] 358
[CUSTOMER][NEUTRAL] 15
[CUSTOMER][NEUTRAL] 358-5315, right?
[AGENT][NEUTRAL] Yes, what's your fax number?
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] It's uh
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, did you have another data service?
[CUSTOMER][NEUTRAL] No, that's, um.
[CUSTOMER][POSITIVE] Thank you for the information. Have a great day. Bye.
[AGENT][POSITIVE] Thank you for calling APL you as well. Bye bye bye.