AccountId: 011433970860
ContactId: 2b9fa008-6058-4588-bcf1-175a95dc019b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 288239 ms
Total Talk Time (AGENT): 82607 ms
Total Talk Time (CUSTOMER): 93020 ms
Interruptions: 1
Overall Sentiment: AGENT=1.1, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/17/2b9fa008-6058-4588-bcf1-175a95dc019b_20250417T20:38_UTC.wav
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[AGENT][NEUTRAL] For calling APL, my name is [PII]. How can I assist you today?
[CUSTOMER][NEUTRAL] Um, yes ma'am, I'm calling because I got a bunch of, I guess what you would call your billing statements or whatever saying that they weren't gonna pay anything on some of my.
[CUSTOMER][NEUTRAL] Um, stuff that was submitted and I'm just trying to figure out why.
[AGENT][POSITIVE] OK, I'll be happy to assist with your claims today. May I have your first name please?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Uh [PII].
[AGENT][POSITIVE] OK, and if I can get a good call back number for you?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And what is the uh policy number?
[CUSTOMER][NEUTRAL] Um, 02479853.
[AGENT][NEUTRAL] OK, if you can verify your last name, date of birth, and email address for me?
[CUSTOMER][NEUTRAL] [PII] [PII] and my email is [PII].
[AGENT][NEUTRAL] Thank you for that information, Ms. [PII] and um what are the data services? Uh, I believe I think I see them as the [PII].
[CUSTOMER][NEUTRAL] There's a lot of them. These, these are all, well, there's a lot of data services. These are all related to Barley Stoker chiropractic.
[AGENT][NEUTRAL] Oh, OK, I see them.
[AGENT][NEUTRAL] OK, so these did not because um you don't, I'm sorry, go ahead.
[CUSTOMER][NEUTRAL] But it, it
[CUSTOMER][NEGATIVE] Because it keeps saying performed in a doctor's office. Well, chiropractic services aren't performed anywhere but a doctor's office, so I don't understand because when they called to see if this was gonna pay on it, they told them they would pay up to $500 and their office called to find out if y'all were gonna pay on it, not me.
[AGENT][NEUTRAL] OK, so
[AGENT][NEUTRAL] The um policy does not have benefits for treatment in an office or clinic setting.
[CUSTOMER][NEUTRAL] I'm starting to wonder, I don't understand that. I get an endoscopy or a colonoscopy, you pay on it.
[AGENT][NEUTRAL] Right, so they must be billing as outpatient, like a surgical facility or hospital.
[CUSTOMER][NEUTRAL] Then why did they tell them when they called there that they would pay up to $500? Like they clearly told them that. That's why I agreed to the treatment.
[AGENT][NEUTRAL] OK, and what, let's see what date?
[CUSTOMER][NEUTRAL] This was back in like January.
[CUSTOMER][NEUTRAL] That they called to find out about their service the.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Well, I'm not sure if they explained that they were calling that they were not outpatient um hospital or surgical um center.
[AGENT][NEUTRAL] If they didn't say that they were calling from a doctor's office or that the treatment would be in a doctor's office.
[CUSTOMER][NEUTRAL] But it's not a doctor's office. It's a chiropractic office.
[AGENT][NEUTRAL] But if they billed as a doctor's office, if if they submitted the bill and they billed under the code of doctor's office, that's why it did not matter of fact, let me pull up the claim and just verify.
[AGENT][NEUTRAL] Yeah, they build under the code of office or clinic setting.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Alright, well thank you.
[AGENT][NEUTRAL] OK, was there anything else I can assist with today?
[CUSTOMER][NEUTRAL] No.
[AGENT][POSITIVE] Thank you for calling APO you have a good day.
[CUSTOMER][NEUTRAL] You too.