AccountId: 011433970860
ContactId: 395ca3cc-eb2b-4e7b-8ce8-1b0b63c34cff
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 370559 ms
Total Talk Time (AGENT): 105502 ms
Total Talk Time (CUSTOMER): 108180 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/21/395ca3cc-eb2b-4e7b-8ce8-1b0b63c34cff_20250521T15:26_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] I'm sorry, I didn't get your name. Could you please spell out your name for me?
[AGENT][NEUTRAL] Yes, it's [PII]
[CUSTOMER][POSITIVE] Thank you so much [PII] just said have you calling from provider office. I'm here to discuss about the claim with you.
[AGENT][NEUTRAL] OK, and can you please spell your first name for me?
[CUSTOMER][NEUTRAL] Sure, sure. It's uh spell out as [PII]
[AGENT][NEUTRAL] OK, thank you, [PII], and um I can help you with the claim status. Can I please get your callback number just in case the call is disconnected?
[CUSTOMER][NEUTRAL] Sure, the uh callback number is [PII].
[AGENT][NEUTRAL] Thank you and what is the member's date of name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Uh, my name is uh.
[CUSTOMER][NEUTRAL] [PII]. Date of birth is [PII], and the policy number is, just allow me a moment.
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] Uh, policy number is 02120618.
[AGENT][NEUTRAL] OK, let me look up that policy real quick.
[CUSTOMER][NEUTRAL] OK, uh, even I have a claim number if you want, uh, I just want to discuss about this claim.
[AGENT][NEUTRAL] OK, just one moment, let me pull in the policy.
[AGENT][NEUTRAL] And then we'll get
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, I'll also need the data service and the charge amount.
[CUSTOMER][NEUTRAL] The date of service is uh [PII] and total charges bill with the claim are.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Just allow me a moment. My system's taking time.
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] OK, so the total charges bill is $264.57.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, and then what are the charges after the primary insurance paid their part?
[CUSTOMER][NEUTRAL] It's $100 even.
[AGENT][NEUTRAL] OK, alright, and may I get the name of the facility you're calling from?
[CUSTOMER][NEUTRAL] I'm calling from Medvice LLC.
[AGENT][NEUTRAL] OK, and then, um, what is that claim number that you have?
[CUSTOMER][NEUTRAL] It's so
[CUSTOMER][NEUTRAL] 358-873-1
[AGENT][NEUTRAL] OK, I'm gonna put you on a brief hold while I look up this claim information and I will be right back here.
[CUSTOMER][NEUTRAL] Sure
[CUSTOMER][POSITIVE] Sure, take your time.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you very much [PII] for holding for me. So looking on this claim number that you gave me 358-873-1, it has a remark on there the benefits for this date of service are being paid directly to the insured.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So how much you have paid to the insured the complete amount of $100?
[AGENT][NEUTRAL] I can't
[AGENT][NEGATIVE] I cannot give that information out.
[AGENT][NEUTRAL] All I can give you is that it's being directly paid to the insured.
[CUSTOMER][NEUTRAL] Uh, could you please provide me other details?
[AGENT][NEUTRAL] Details, that is the only detail that is being paid directly to the insured.
[CUSTOMER][NEUTRAL] OK, so we can just bill this claim to patient, and they, they will definitely, uh, refund the, uh, the money.
[AGENT][NEUTRAL] We don't give patient responsibility that's determined by the provider.
[CUSTOMER][NEUTRAL] OK, so, uh, you are not saying that we have to build this claim to patient. It's our choice.
[AGENT][NEGATIVE] Right, we don't give patient responsibility.
[CUSTOMER][NEUTRAL] OK, not a problem. Uh, may I have the policy number for this call?
[AGENT][NEUTRAL] Yes, ma'am. You can use my name [PII] and today's date.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][POSITIVE] OK, thank you so much and have a great day. Bye for now.
[AGENT][POSITIVE] You have a wonderful day too, [PII]. Thank you for calling APL. Bye-bye.
[CUSTOMER][NEUTRAL] OK, bye bye.