AccountId: 011433970860
ContactId: 1fcc2d2b-df07-4e55-a53e-391b821020ef
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 346230 ms
Total Talk Time (AGENT): 113158 ms
Total Talk Time (CUSTOMER): 132521 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/11/1fcc2d2b-df07-4e55-a53e-391b821020ef_20250211T14:47_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Good morning. My name is [PII] and I'm calling just regarding a claim status.
[AGENT][NEUTRAL] OK, I can verify claim status for you and you say your name is [PII]?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, and what is that policy number, please?
[CUSTOMER][NEUTRAL] Uh, the policy number is, let me just one second, 21101.
[AGENT][NEUTRAL] No, sir, it's not a policy number. Uh, do you have a copy of the card in front of you?
[CUSTOMER][NEUTRAL] Oh, you mean the insured ID number? Yeah, I got it. It's 201.
[CUSTOMER][NEUTRAL] 075.
[CUSTOMER][NEUTRAL] 43.
[AGENT][NEUTRAL] OK, thank you. One moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Uh, it's too many numbers. What's the patient's name, date of birth?
[CUSTOMER][NEUTRAL] It is [PII] and his date of birth is [PII].
[AGENT][NEUTRAL] Uh, spell that first name.
[CUSTOMER][NEUTRAL] Uh, [PII] and then [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, and OK, and do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] Sure, let me give it to you one second.
[CUSTOMER][NEUTRAL] My callback number will be [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and you're saying you're calling for claim status, correct?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] That is correct.
[AGENT][NEUTRAL] Um, what was the date of service and the amount of the charge?
[CUSTOMER][NEUTRAL] Sure, the date of service was [PII] and the bill amount was $336.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] And you're calling from?
[CUSTOMER][NEUTRAL] Uh, Arden Arden Health Services.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, I'm showing that claim process as office visits are not covered, nor procedures performed in a doctor's office or clinic.
[CUSTOMER][NEUTRAL] OK, so basically, uh, there, I mean, is not a network service, so you're gonna pay it.
[AGENT][NEUTRAL] No, we don't have a network. The policy, the patient's policy does not cover office visits, nor does it cover any procedures in the office, so it is not covered.
[CUSTOMER][NEUTRAL] Oh, OK, I don't understand. So in this case we'll she like bill this uh remaining balance to the patient. Am I right?
[AGENT][NEUTRAL] Uh, we can't tell you about patient responsibility. We can only verify how the claim was processed and which process is not covered.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Oh, OK, OK.
[CUSTOMER][NEUTRAL] Oh OK, I do understand. Uh, thank you so much for your help. Um, let me ask you a quick question. uh, if, are you just for, uh, like, uh, to, to ask, um, how many claims can you help me with like in the same interaction or call?
[AGENT][NEUTRAL] Uh, we don't really have a limit. Do you have another claim you want to check for this patient or a different patient?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No, I'm just, uh, asking to have like multiple claims before calling to see if you can help me with multiple claims, but now that you say that you don't have a number, that's totally fine. And let me ask you another quick question do you have a fax number or mailing address to send medical records or any other documentation that you may need?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] For a claim?
[AGENT][NEUTRAL] Yes. Our fax number is [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 942 3.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mailing address is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, could you repeat me the zip code again? I'm sorry, I couldn't catch it.
[AGENT][NEUTRAL] Sure. [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK, thank you so much for your help. I hope, I hope you have a wonderful day. Have a good one, OK?
[AGENT][POSITIVE] Alright, you, you too, [PII], and thank you for calling APL.
[CUSTOMER][NEUTRAL] Oh, I'm sorry, do you have a reference number for me before I hanging out? I'm sorry.
[AGENT][NEUTRAL] No, we don't give reference numbers. You may use my name in today's date.
[CUSTOMER][POSITIVE] Oh OK, thank you so much. Have a good one.
[AGENT][POSITIVE] You're welcome. You too. Bye.