AccountId: 011433970860
ContactId: 0b217759-fb7e-48b0-b3b6-ccc8f60bdaf8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 477130 ms
Total Talk Time (AGENT): 145539 ms
Total Talk Time (CUSTOMER): 169055 ms
Interruptions: 1
Overall Sentiment: AGENT=0.5, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/23/0b217759-fb7e-48b0-b3b6-ccc8f60bdaf8_20250623T13:48_UTC.wav
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[AGENT][POSITIVE] And thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from provider office for checking on your claim status. Can you please help me with that?
[AGENT][NEUTRAL] I'm sure, [PII], I can assist you with claim status. First, could I get a good callback number just in case we're disconnected?
[CUSTOMER][NEUTRAL] I'm sure.
[CUSTOMER][NEUTRAL] Yeah, the good call back number is [PII] and extension is [PII].
[AGENT][NEUTRAL] Thank you. Now I need the policy number, please.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] The policy number is 2320076.
[AGENT][NEUTRAL] Please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] The patient name is [PII]. The date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you. Now I need the date of service and bill charges on the claim.
[CUSTOMER][NEUTRAL] The date of service is [PII] and the charge amount is $288 even.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] OK. Yes, sir. We received that claim on [PII].
[CUSTOMER][NEUTRAL] Like
[AGENT][NEUTRAL] The claim processed on [PII].
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] The claim number is 3492484.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And this claim denied because office visits are not covered under the patient's plan.
[CUSTOMER][NEUTRAL] I first visits.
[CUSTOMER][NEGATIVE] Would not go up.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Just give me a second.
[CUSTOMER][NEUTRAL] And could you send me a copy of your?
[AGENT][NEUTRAL] Um, yes, what's your fax number?
[CUSTOMER][NEUTRAL] And the fax number is
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Mm. So that fax number is it?
[CUSTOMER][NEUTRAL] And uh yes.
[AGENT][NEUTRAL] I'm sorry. Go ahead.
[CUSTOMER][NEUTRAL] That is the fax number.
[AGENT][NEUTRAL] OK. And with that, I attention that to you?
[CUSTOMER][NEUTRAL] And can I have the call reference number?
[CUSTOMER][NEUTRAL] Attention to [PII] and last initial is KK for kilo.
[AGENT][NEUTRAL] OK, so that's attention [PII] K [PII]?
[CUSTOMER][POSITIVE] That's correct.
[AGENT][NEUTRAL] OK. You should receive it in about 10 minutes and the reference number for this call is my name and today's date. My name is [PII]'s spelled [PII], and today's date. Um, is there anything else I can assist you with?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] I do have one more claim.
[CUSTOMER][NEUTRAL] Uh, got you.
[AGENT][NEUTRAL] Is it for the same number?
[CUSTOMER][NEUTRAL] No, it's a different number.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] And what's that policy number, please?
[CUSTOMER][NEUTRAL] And uh
[CUSTOMER][NEUTRAL] The policy number is 229917-6.
[CUSTOMER][NEUTRAL] And the patient's name is [PII].
[CUSTOMER][NEUTRAL] The date of birth is [PII].
[CUSTOMER][NEUTRAL] all
[AGENT][NEUTRAL] OK. One moment, please.
[CUSTOMER][NEUTRAL] The
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] 2550.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] When
[CUSTOMER][NEUTRAL] the
[AGENT][NEUTRAL] I'm still waiting on my system. One moment, please.
[CUSTOMER][NEUTRAL] I'm still waiting on.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] with it
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Only?
[AGENT][NEUTRAL] OK, I'm sorry. Could I get that policy number one more time?
[CUSTOMER][NEUTRAL] And the policy number is 229-9176.
[AGENT][NEUTRAL] And please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] The first name is [PII] and the last name is [PII]. The date of birth is [PII].
[AGENT][NEUTRAL] OK, there he is. And what's the date of service and bill charges on the client?
[CUSTOMER][NEUTRAL] The date of service is [PII] and the charge amount is $408 even.
[AGENT][NEUTRAL] And that's [PII].
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, yes, we received that claim on [PII].
[AGENT][NEUTRAL] It processed on [PII].
[AGENT][NEUTRAL] The claim number is 3,505,550 and it's also denying um office visits not covered under patient's plan.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] May I know how many visits per year and how many visits the, do the patient make?
[AGENT][NEUTRAL] Office visits are not covered under the plan.
[CUSTOMER][NEUTRAL] Yes, yes, I understand. May I know the visit limit?
[AGENT][NEUTRAL] 0 because office visits are not covered.
[CUSTOMER][NEUTRAL] When was the office visit last met?
[CUSTOMER][NEUTRAL] Is there any information?
[AGENT][NEGATIVE] No, sir, because office visits are not covered under this plan. All office visits um that are billed to this plan, they deny.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All of
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Got it. And can I have the EV for this number also?
[AGENT][NEUTRAL] Yeah, and the fax number again is [PII].
[CUSTOMER][NEUTRAL] To the same fax number.
[CUSTOMER][POSITIVE] Yes, correct.
[AGENT][POSITIVE] OK. Yes, sir. I'll get that faxed to you as well. Is there anything else I can assist you with?
[CUSTOMER][POSITIVE] Nothing you want. That's it for today. Thank you for your assistance.
[AGENT][POSITIVE] OK, thank you again, [PII], for calling APL. You have a great rest of your day. Mm bye.
[CUSTOMER][POSITIVE] Thank you. Bye-bye.