AccountId: 011433970860
ContactId: 17da52d8-198b-4eea-9fb7-dd99624020ed
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 243639 ms
Total Talk Time (AGENT): 81301 ms
Total Talk Time (CUSTOMER): 74645 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=2.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/14/17da52d8-198b-4eea-9fb7-dd99624020ed_20250214T13:36_UTC.wav
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[AGENT][NEUTRAL] For calling APL, this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Uh hello [PII]. My name is [PII] calling from provider's office in order to check a medical claims. Could you please assist me with that?
[AGENT][NEUTRAL] I can help you, [PII]. What's the policy number?
[CUSTOMER][NEUTRAL] All right. Um, well, here we go with the policy number which is 01851923 M as in Mike, L as in Lima, number 8.
[AGENT][NEUTRAL] And what's a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]. There's no extension, it's a direct line. And Ms. [PII], may I get your last name initial, please?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII] and you'll use my name and today's date as reference for today's call, uh, [PII].
[CUSTOMER][POSITIVE] Mhm. Thank you. Yeah, thank you.
[AGENT][NEUTRAL] And what's the patient's, uh-huh, what's the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Well, the member's name is A ready for the birth date, [PII].
[AGENT][NEUTRAL] OK, thank you and you said that you're checking a coin status?
[CUSTOMER][POSITIVE] Yes, that is correct.
[AGENT][NEUTRAL] And what's the date of service in charge?
[CUSTOMER][NEUTRAL] But the service date was [PII], the total bill amount of $658 even.
[AGENT][NEUTRAL] And what are, what are the procedure codes on that claim?
[CUSTOMER][NEUTRAL] All right. Uh, that was 992-04810253641581002.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] So I show this claim was received [PII], processed [PII].
[AGENT][NEUTRAL] Uh, give me a second. That's actually a duplicate. Let me find the original claim.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Alright, so the original claim was received [PII], processed [PII].
[AGENT][NEUTRAL] And there was not a payment made, uh, that reason being the office visit fee and then the treatment codes in the office is not covered under the patient's policy. I'm showing the claim number is 349.
[AGENT][NEUTRAL] 74.
[AGENT][NEUTRAL] 72
[CUSTOMER][NEUTRAL] OK. You're stating that denied as a non-covered charges, right?
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] And did you have any other questions?
[CUSTOMER][NEUTRAL] Um, could I please get the duplicate claim number?
[AGENT][NEUTRAL] That claim number is 353-466-2.
[CUSTOMER][NEUTRAL] OK. One moment, please.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] All right, thank you so much. As you said, the call reference number is your name and today's date. Am I correct?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Thank you so much, uh, [PII] for all your assistance. Hope you have a very wonderful day. Bye for now. Yeah. Thank you. Bye-bye.
[AGENT][POSITIVE] Oh, you're welcome.
[AGENT][POSITIVE] Thank you for calling APL. Have a good day bye bye.
[CUSTOMER][POSITIVE] Have a great day too