AccountId: 011433970860
ContactId: 0bb28dc0-e9c9-4064-8fa5-55b5e849cca3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 235289 ms
Total Talk Time (AGENT): 87359 ms
Total Talk Time (CUSTOMER): 69857 ms
Interruptions: 0
Overall Sentiment: AGENT=1.5, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/14/0bb28dc0-e9c9-4064-8fa5-55b5e849cca3_20250514T13:58_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] from [PII]'s office. I'm looking for the status of the claim. Can you help me out?
[AGENT][NEUTRAL] Sure, I can verify the claim status for you, [PII]. And what is the policy number, please?
[CUSTOMER][NEUTRAL] The policy number 02117284.
[AGENT][POSITIVE] OK, thank you so much. And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. And verify the patient's name, date of birth?
[CUSTOMER][NEUTRAL] Can I repeat again.
[CUSTOMER][NEUTRAL] Patient name is gonna be uh [PII]. Last name is [PII] Date of birth [PII]. It's [PII].
[AGENT][NEUTRAL] OK, thank you. And what was the date of service and the amount of the charge?
[CUSTOMER][NEUTRAL] Data service for this one is gonna be [PII] [PII] 2025ching more $190.
[AGENT][POSITIVE] OK, thank you, give me one moment.
[AGENT][NEUTRAL] OK, and while I'm looking up claim information let you know we do have an online service center where providers can check claim status as well as print out the EOB. That site is at [PII]. And what is the name of the provider's office?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It's got the bro.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] One moment please.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And what was the provider's name again? I apologize.
[CUSTOMER][NEUTRAL] Ther's name is Doctor [PII].
[AGENT][NEUTRAL] OK. I'm showing that claim processed as office visits are not covered per the policy.
[CUSTOMER][NEUTRAL] What's the claim number?
[AGENT][NEUTRAL] 359-2108.
[CUSTOMER][NEUTRAL] OK, and the amount is patient responsibility?
[AGENT][NEUTRAL] Uh, we can't give patient responsibility. We can only verify how it was processed, which is not covered per the policy.
[CUSTOMER][NEUTRAL] OK, what's the policy number as per policy do you have any uh.
[CUSTOMER][NEUTRAL] Guidelines
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Uh, like which guidelines you guys follow, Medicare guidelines or you guys have follow your own guidelines?
[AGENT][NEUTRAL] Uh, we follow our own guidelines.
[CUSTOMER][NEUTRAL] You are the supplement plan or the secondary plan.
[AGENT][NEUTRAL] Uh, secondary.
[CUSTOMER][NEUTRAL] Secondary, OK.
[CUSTOMER][POSITIVE] OK, thank you so much. How do you spell your name?
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And [PII], is there anything else I can assist you with today?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] No, thank you so much. When was the claim denied on if you have that information?
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] A claim process on [PII] of this year.
[CUSTOMER][NEUTRAL] Thank you and the reference number your name on today's date?
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] Thank you so much. Have a great day. Take care and stay safe.
[AGENT][POSITIVE] You too, thank you for calling APL bye.
[CUSTOMER][NEUTRAL] Bye.