AccountId: 011433970860
ContactId: 22da557d-3867-47d0-b1af-0fdfda63a64b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 228880 ms
Total Talk Time (AGENT): 89922 ms
Total Talk Time (CUSTOMER): 48997 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/06/22da557d-3867-47d0-b1af-0fdfda63a64b_20250206T17:23_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes, I was calling to see if a claim has been received for a patient.
[AGENT][NEUTRAL] OK, yeah, I can check on a claim for you. uh, what was your name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Oh [PII]. I'm sorry.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, uh, can I get a good call back number for me really quick in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes, it is [PII].
[AGENT][NEUTRAL] OK, thank you. And then do you have that policy number?
[CUSTOMER][NEUTRAL] Yes, that is 02312899.
[AGENT][NEUTRAL] Alright, thank you. And what was the name and date of birth for the insured?
[CUSTOMER][NEUTRAL] Uh, [PII], date of birth is [PII].
[AGENT][NEUTRAL] Perfect, thank you for verifying that [PII] and uh what was the date of service for this claim?
[CUSTOMER][NEUTRAL] It is [PII] for $150.
[CUSTOMER][NEUTRAL] Yeah, for $150. No, I'm sorry.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] That was 150?
[CUSTOMER][NEUTRAL] The crossover claim should have been for 4000, yeah.
[AGENT][NEUTRAL] Oh, was the 150 what was left over after uh major medical? I got you. OK, perfect. Thank you. One moment please.
[CUSTOMER][NEUTRAL] But it looks like we we.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Uh, I'm sorry, [PII], what was the name of the, uh, provider's office this was with?
[CUSTOMER][NEUTRAL] Oh Georgetown physician Associates.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Oh, was it just the one procedure code [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, uh 99213?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK got it so it looks like um we did receive that twice I think it was also a part of another claim, a previous one that had multiple line items on it um but it's for that same date of service from y'all. Let me go back to that one.
[AGENT][NEUTRAL] So the original claim that that one was on it did.
[AGENT][NEUTRAL] Deny as office visits are not covered under this policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Is there a claim number?
[AGENT][NEUTRAL] Yes, um, that is 34 yes 3484592.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, are you able to give me a call reference number for today's call?
[AGENT][NEUTRAL] It would just be my first name, last initial, and today's date. Uh, so my name is spelled [PII] Uh, was there anything else I could help you with [PII]?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][POSITIVE] Uh, that'll be it. Thank you so much.
[AGENT][POSITIVE] OK, yeah, thanks for calling HPL. I hope you have a great rest of your day.