AccountId: 011433970860
ContactId: 15e6c8a8-b458-471f-abd1-4ee1c3dc17fd
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 206889 ms
Total Talk Time (AGENT): 69143 ms
Total Talk Time (CUSTOMER): 104124 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/23/15e6c8a8-b458-471f-abd1-4ee1c3dc17fd_20250523T16:13_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi, you, how did, what, what did you say your name was?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Oh, well, my name is, I thought I heard it right. My name is [PII]
[AGENT][NEUTRAL] Oh, OK, how about that say if you said [PII], I was like, alright.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] That'd be cool though. I'll be like, oh, that's the first kick here in Salsa too.
[AGENT][NEUTRAL] Well, I've had someone call with though, but go ahead, I'm sorry.
[CUSTOMER][NEUTRAL] Um, I'm calling for the
[CUSTOMER][POSITIVE] Really? Oh, that's pretty cool. Um,
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] I'm calling from the provider's office regarding a claim that was denied. I'm just trying to get further uh details on what the denial reason was.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, I can verify claim status for you. Um, Ms. [PII], what is that policy number, please?
[CUSTOMER][NEUTRAL] I have 02544110.
[AGENT][NEUTRAL] Thank you. And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[AGENT][NEUTRAL] OK. And the patient's name, date of birth?
[CUSTOMER][NEUTRAL] Uh, patient's name is [PII] and it's uh [PII].
[AGENT][NEUTRAL] OK, thank you, ma'am. And do you have the claim number or the date of service and the amount of the charge?
[CUSTOMER][NEUTRAL] Um, yeah, I believe I have a claim number of 358-629-1. Uh, the date of service is $325.25 dollars for $277.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, give me one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And it looks like that claim processes, office visits are not covered for the policy.
[CUSTOMER][NEUTRAL] Oh, that's weird. It usually office visits was normally covered. So office visit not covered by patients policy?
[AGENT][NEUTRAL] Uh, yes, ma'am.
[CUSTOMER][NEUTRAL] Covered by this policy, OK, and you guys are primary for this number, right?
[AGENT][NEUTRAL] Uh, no, ma'am, secondary.
[CUSTOMER][NEUTRAL] Secondary, oh, who do you guys show as primary because they're showing you guys as primary.
[AGENT][NEUTRAL] Uh, let's see.
[AGENT][NEUTRAL] Yeah, because this policy is a secondary supplemental plan only, so they have to have a primary, that would be through their employer.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] All the supplement.
[CUSTOMER][NEUTRAL] OK, they
[AGENT][NEUTRAL] And
[CUSTOMER][NEUTRAL] OK. Yeah, I do, I do see a few here.
[AGENT][NEUTRAL] Uh, looks like we have listed as Blue Cross Blue Shield.
[CUSTOMER][NEUTRAL] Sure, OK, we have listed as
[CUSTOMER][NEUTRAL] Uh, Amber.
[CUSTOMER][POSITIVE] Huh, interesting.
[CUSTOMER][NEUTRAL] OK. I will have to get with the patient to get all this verified because they're having, there's like 3 other insurance on file too, so I have to get that cleared up with them.
[AGENT][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] OK dokey. Is there, is there a reference number, number I can take down, [PII]?
[AGENT][NEUTRAL] Uh, if you like, you may use my name at today's date.
[CUSTOMER][POSITIVE] Oh, OK, great. Thank you so much for your help today.
[AGENT][POSITIVE] Oh, you're welcome. Thank you for calling APL. Have a great day, Ms. Kia and a weekend.
[CUSTOMER][POSITIVE] Bye bye bye. You too. Take care. Bye-bye.
[AGENT][NEUTRAL] Bye.