AccountId: 011433970860
ContactId: 08b73a3a-79a3-41b8-ba82-b62dc485d4c1
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 349839 ms
Total Talk Time (AGENT): 75353 ms
Total Talk Time (CUSTOMER): 135265 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/08/08b73a3a-79a3-41b8-ba82-b62dc485d4c1_20250408T13:47_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yeah, hi [PII]. Good morning. My name is [PII], and last termination [PII]. I'm calling from provider's office regarding claim status.
[AGENT][NEUTRAL] OK, [PII], I can help you with claim status. Do you have a good call back number?
[CUSTOMER][NEUTRAL] Yeah, sure. [PII]. It is a direct line.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, thank you. Do you have the policy number of the patient?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] The first policy number is 02566408.
[AGENT][NEUTRAL] And patient name and date of birth?
[CUSTOMER][NEUTRAL] Yeah, the patient name is [PII] and the date of birth [PII].
[AGENT][NEUTRAL] And the date of service?
[CUSTOMER][NEUTRAL] Yeah, it's [PII]. And the total charge is $542 even.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEGATIVE] Uh, it looks like we received that 3-14-2025. It was denied on [PII].
[AGENT][NEUTRAL] And it looks like.
[AGENT][NEUTRAL] Office visits are not covered under the plan.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] May I have the claim number?
[AGENT][NEUTRAL] 357-7568
[CUSTOMER][NEUTRAL] Yeah, sure. Just give me a moment.
[CUSTOMER][NEUTRAL] OK, yeah.
[CUSTOMER][NEUTRAL] 7:21.
[CUSTOMER][NEUTRAL] I sounded.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah. Thank you, [PII]. Uh, let's move to another claim.
[AGENT][NEUTRAL] OK, for a different patient.
[CUSTOMER][NEUTRAL] Yeah, it's a different patient.
[AGENT][NEUTRAL] OK, policy number?
[CUSTOMER][NEUTRAL] Um, just give me a moment, it's loading.
[CUSTOMER][NEUTRAL] Yeah, the policy number is 01896036M for [PII], L for Lima.
[CUSTOMER][NEUTRAL] After 8.
[AGENT][NEUTRAL] And patient name and date of birth?
[CUSTOMER][NEUTRAL] OK, one second.
[CUSTOMER][NEUTRAL] The patient name is [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you and do you have the data of service?
[CUSTOMER][NEUTRAL] The date of service is [PII] and the total charge $2610 even.
[AGENT][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Facebook
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] You know.
[AGENT][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] the.
[AGENT][NEUTRAL] Uh, looks like you received it on [PII], denied on [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And let's see here.
[CUSTOMER][NEUTRAL] I I.
[AGENT][NEUTRAL] Uh, the benefit for the calendar year had been maxed.
[CUSTOMER][NEUTRAL] So it's Max existed benefits.
[AGENT][NEUTRAL] says magazine.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] The denial reason, may I know the denial is one more time?
[AGENT][NEUTRAL] Outpatient benefit for the calendar year has been met.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And the claim number?
[AGENT][NEUTRAL] 3506454
[CUSTOMER][NEUTRAL] OK, one second.
[CUSTOMER][NEUTRAL] Uh, can you please send any of it through fax?
[AGENT][NEUTRAL] Uh yes, give me one moment.
[AGENT][NEUTRAL] OK, what's your fax number?
[CUSTOMER][NEUTRAL] Yeah, sure. Uh, it's [PII].
[CUSTOMER][NEUTRAL] [PII]. And also, can you please put attention my name, [PII]?
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Thank you, [PII], and may I know the call reference number?
[AGENT][NEUTRAL] And did you have more
[AGENT][NEUTRAL] Oh, call reference number is my name [PII], first initial to last name [PII], and today's date.
[CUSTOMER][NEUTRAL] She
[CUSTOMER][POSITIVE] Yeah, thank you.
[AGENT][POSITIVE] OK, thanks for calling APL have a great day.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah, same to you, bye-bye.
[AGENT][NEUTRAL] Bye