AccountId: 011433970860
ContactId: 36910ee0-69e4-4332-8ce1-4b7cb61329e2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 283920 ms
Total Talk Time (AGENT): 86989 ms
Total Talk Time (CUSTOMER): 71859 ms
Interruptions: 0
Overall Sentiment: AGENT=1.5, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/31/36910ee0-69e4-4332-8ce1-4b7cb61329e2_20250331T15:07_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII] and I'm calling from provider office. I want to know claim status.
[CUSTOMER][NEUTRAL] Mm
[AGENT][POSITIVE] OK, I'm happy to check on a claim for you today. Do you have the patient's policy number?
[CUSTOMER][NEUTRAL] Yeah, the patient policy number is 02538.
[CUSTOMER][NEUTRAL] 441.
[AGENT][NEUTRAL] Thank you, [PII] and then do you have a good callback number?
[CUSTOMER][NEUTRAL] Yeah, the callback number is [PII].
[AGENT][NEUTRAL] Thank you for that. And then may I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yeah, the patient name.
[CUSTOMER][NEUTRAL] Allow a minute. Yeah, the page.
[CUSTOMER][NEUTRAL] Yeah, the patient name is
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And the date of birth is
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you for that. And then what is the date of service?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the build amount.
[CUSTOMER][NEUTRAL] The bill amount is
[CUSTOMER][NEUTRAL] $153.83.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] So we did receive a claim for the state of service on [PII].
[AGENT][NEUTRAL] The claim was denied. Medical equipment is not covered under the patient plan.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And what, um.
[CUSTOMER][NEUTRAL] Can you please provide the plan name of which uh the patient have?
[AGENT][NEUTRAL] We are the secondary insurance, so this is a Medlink plan.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh, the patient plan name, can you please provide?
[AGENT][NEUTRAL] It's a meddling plan.
[CUSTOMER][NEUTRAL] Madeline.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] M as in Mary, E as in Echo, D as in Delta.
[CUSTOMER][NEUTRAL] Can you please spell
[AGENT][NEUTRAL] And then L as in Lima, I as in India, N as in November, K as in Kilo.
[CUSTOMER][NEGATIVE] Is Mali.
[CUSTOMER][NEUTRAL] It is the patient plan name.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Or it is not covered DME.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] It is PPO or HMO, which type of plan?
[AGENT][NEUTRAL] Neither. We're the secondary, so it's not a PPO or an HMO. We pick up the deductible co-pay, co-insurance from the primary.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So it is not covered the deductibles also.
[AGENT][NEUTRAL] Correct, because medical equipment is not covered under the patient plan.
[CUSTOMER][NEUTRAL] Medical equipment is not covered under the patient plan.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] It's that link. OK, thank you.
[AGENT][POSITIVE] You're welcome. Is there anything else I can check on for you?
[CUSTOMER][NEUTRAL] No.
[AGENT][POSITIVE] Thank you for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] Can you give me the call reference number for this?
[AGENT][NEUTRAL] Call references my name with my last initial than today's date. My name again is [PII], that's [PII]
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] My last initials [PII].
[CUSTOMER][POSITIVE] Thank you, sir.
[AGENT][POSITIVE] You're welcome. Have a good day.
[CUSTOMER][NEUTRAL] Bye.