AccountId: 011433970860
ContactId: 2a6b04ae-95ed-4a43-9a93-0bae07544ecd
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 306359 ms
Total Talk Time (AGENT): 98561 ms
Total Talk Time (CUSTOMER): 92234 ms
Interruptions: 1
Overall Sentiment: AGENT=1.5, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/29/2a6b04ae-95ed-4a43-9a93-0bae07544ecd_20250529T17:19_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII], and I am calling uh regarding a uh secondary claim that we have been trying to get you guys. We, we faxed it, we've mailed it like 4 times, so I'm hoping you guys received it by now.
[AGENT][NEUTRAL] Yes, ma'am. Oh my, OK.
[AGENT][NEUTRAL] OK, Ms. [PII], I can check your claim status for you. Uh, can you please give me your callback number, ma'am?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Sure, it's [PII], and that is a direct line.
[AGENT][NEUTRAL] OK, thank you. And then what is the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] OK, it's [PII] Date of birth is [PII], and it looks like the policy number is 02124055.
[AGENT][NEUTRAL] OK, let me pull that policy up real quick.
[AGENT][NEUTRAL] OK and then can you please give me the data service and the charge amount?
[CUSTOMER][NEUTRAL] Uh, data services 1121 of 24.
[CUSTOMER][NEUTRAL] And the amount is 2 just 250, it was an office visit.
[AGENT][NEUTRAL] 250, OK.
[CUSTOMER][NEUTRAL] And you guys are really secondary, so yeah, the customer shield already paid.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and then what was the charges after the primary paid their part?
[CUSTOMER][NEUTRAL] Um, it looks like they applied $50 to copay.
[AGENT][POSITIVE] OK, thank you and.
[CUSTOMER][NEUTRAL] So after everything, the only thing that's left of the patient is 50.
[AGENT][NEUTRAL] OK, thank you. And then that's no, that's fine. And then what is the name of the facility you're calling from?
[CUSTOMER][NEUTRAL] Sorry.
[CUSTOMER][NEUTRAL] The physicians group?
[CUSTOMER][NEUTRAL] Uh, to the Oklahoma Skin Associates, Doctor Nen actually [PII] is the one that's see the patient.
[AGENT][NEUTRAL] Uh.
[AGENT][POSITIVE] OK, thank you. I appreciate all the information you've given me, Miss [PII]. I'm gonna put you on a quick hold while I search for this claim for you and I'll be right back.
[CUSTOMER][POSITIVE] Awesome thank you so much.
[AGENT][POSITIVE] You're very welcome.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Hm, it's right there.
[AGENT][NEUTRAL] 3581597.
[AGENT][NEUTRAL] 358 1.
[AGENT][NEUTRAL] 5
[AGENT][NEUTRAL] 97.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Hi Ms. [PII], this is [PII]. I've got the claim information for you.
[CUSTOMER][NEUTRAL] Uh huh oh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, I'm ready.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] Yes, ma'am. The claim number is 35815997 and the claim has been denied because office visits are not covered under the patient's plan.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Not covered under patient plan awesome, can I get a call reference number real quick?
[AGENT][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Yes, you can use my name, [PII], and today's date.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] And today's date [PII]. Awesome thank you so much I appreciate your help.
[AGENT][POSITIVE] You're so very welcome, Ms. [PII]. I hope you have a wonderful day. Is that everything I can help you with?
[CUSTOMER][POSITIVE] Yes ma'am, that is it and you have a fabulous day too.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you. You take care. Thanks for calling APL. Bye-bye, ma'am.
[CUSTOMER][NEUTRAL] Bye bye.