AccountId: 011433970860
ContactId: 388e144a-874c-499d-9556-068bd9ef3078
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 194210 ms
Total Talk Time (AGENT): 48779 ms
Total Talk Time (CUSTOMER): 54339 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/16/388e144a-874c-499d-9556-068bd9ef3078_20250516T18:46_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] and I'm calling for provider to check on additional information about a claim that has been denied. Please note this call will be monitored and recorded for quality and training purposes.
[AGENT][POSITIVE] All right, I'm happy to check on a claim. What's the policy number?
[CUSTOMER][NEUTRAL] Sure. The policy number is 1359432 M as in Mike L as in Lima 7.
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] Patient's name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Data service.
[CUSTOMER][NEUTRAL] Hm. Date of service is [PII].
[AGENT][NEUTRAL] In the build amount?
[CUSTOMER][NEUTRAL] $330 even.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Do you have a different billed amount after the primary paid than $330?
[CUSTOMER][NEUTRAL] Is it $255 even?
[AGENT][NEUTRAL] Yes, I have one for that. Let me pull it up here one moment.
[AGENT][NEUTRAL] Alright. Thank you for your patience on that. So we did receive a claim for the date of service. I was denied durable medical equipment is not covered under the member policy, neither are office visits.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Can I get the patient's policy name?
[AGENT][NEUTRAL] Uh, we are their secondary plan. It's a meddling plan.
[CUSTOMER][POSITIVE] modeling plan. Thank you for that.
[CUSTOMER][NEUTRAL] And is it a patient responsibility?
[AGENT][NEUTRAL] We're not able to advise on patient responsibility that's up to the facility or provider.
[CUSTOMER][NEUTRAL] OK, thank you for that. And can I get the call reference for this number?
[AGENT][NEUTRAL] Call reference is my name with today's date.
[CUSTOMER][POSITIVE] Thank you, [PII]. Thank you for patiently assisting me today. I hope you have a great day.
[AGENT][NEUTRAL] You too bye bye.