AccountId: 011433970860
ContactId: 0db76c6f-4390-47a9-94fc-b2fd1424f1a3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 158630 ms
Total Talk Time (AGENT): 55753 ms
Total Talk Time (CUSTOMER): 64546 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/21/0db76c6f-4390-47a9-94fc-b2fd1424f1a3_20250421T14:57_UTC.wav
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[AGENT][NEUTRAL] For calling APL, my name is [PII]. How can I assist you today?
[CUSTOMER][NEUTRAL] Hi, I'm calling to check to see if you guys have received a claim.
[AGENT][POSITIVE] I'd be happy to assist with claim status. May I have your first name please?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] And [PII], if I can get a good callback number for you?
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[AGENT][NEUTRAL] And what is the policy number?
[CUSTOMER][NEUTRAL] Policy number is 1455717.
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII], date of birth is [PII].
[AGENT][NEUTRAL] Thank you for that and what's the um date of service for the claim?
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] And your tax ID.
[CUSTOMER][NEUTRAL] Uh, oh, let me pull that back up. Tax ID it is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you for that information. um, it looks like we received.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] What's the CPT code because it looks like you billed for.
[CUSTOMER][NEUTRAL] 88305.
[AGENT][NEUTRAL] OK, so I do show that claim did not because office visits are not covered under the policy.
[CUSTOMER][NEUTRAL] This isn't an office visit.
[CUSTOMER][NEUTRAL] It was a lab
[CUSTOMER][NEUTRAL] Like a pathology.
[AGENT][NEUTRAL] OK, and when you submitted the claim form, was it submitted with place the service 11?
[CUSTOMER][NEUTRAL] Uh, let me check, let me check. Yes, it was OK.
[AGENT][NEUTRAL] So that's why I deny because office, anything dealing with an a treatment in an office or clinic setting is not covered under the policy.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, um.
[CUSTOMER][NEUTRAL] Is there, can I go online and pull that rebbi or EOB?
[AGENT][NEUTRAL] Yes, let me give you that claim number.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] It's 358.
[AGENT][NEUTRAL] 3730.
[CUSTOMER][NEUTRAL] 30 perfect. Can I get a call reference number?
[AGENT][NEUTRAL] Reference is just my name [PII] last initial S as [PII], and the date and time of the call. Was there anything else I could assist with today?
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][POSITIVE] No, that'll be all thank you so much you've been a great help.
[AGENT][POSITIVE] Thank you for calling APL you have a good day.
[CUSTOMER][NEUTRAL] You as well bye bye.