AccountId: 011433970860
ContactId: 402e22aa-deb4-4758-8053-d92cb8bd1c86
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 467250 ms
Total Talk Time (AGENT): 103732 ms
Total Talk Time (CUSTOMER): 115477 ms
Interruptions: 0
Overall Sentiment: AGENT=0.1, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/29/402e22aa-deb4-4758-8053-d92cb8bd1c86_20250429T15:53_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh, he, I, I'm [PII] calling from provider's office to check on the claim status.
[AGENT][NEUTRAL] Uh, sure, I can help you with claim status, and I missed your name. What was your name?
[CUSTOMER][NEUTRAL] It's [PII]
[AGENT][NEUTRAL] You have a good callback number, [PII]?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK. And do you have the policy number of the patient?
[CUSTOMER][NEUTRAL] Yeah, D as in it's D47305915.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] And what is the last name?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Is that [PII]?
[CUSTOMER][NEUTRAL] It's OK, it's [PII]
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] OK, could you spell that again? I'm sorry.
[CUSTOMER][NEUTRAL] OK. It's [PII]
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It
[AGENT][NEUTRAL] And the first name?
[CUSTOMER][NEUTRAL] not
[AGENT][NEUTRAL] Uh, I'm sorry, was it [PII]?
[CUSTOMER][NEUTRAL] Oh yeah.
[AGENT][NEUTRAL] And the patient's date of birth?
[CUSTOMER][NEUTRAL] OK, it's [PII].
[AGENT][NEUTRAL] And the date of service and bill charges?
[CUSTOMER][NEUTRAL] [PII] and it's for $670.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] OK, it looks like
[AGENT][NEUTRAL] Uh, that was received on [PII].
[AGENT][NEUTRAL] And process 2-10-2025.
[AGENT][NEUTRAL] And let's see.
[AGENT][NEUTRAL] Uh, it looks like it's not covered under the policy. Inpatient visits by a physician are not covered under the policy.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] For the members not covered?
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] So, the, the benefit is not covered under the policy.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, so the code.
[CUSTOMER][NEUTRAL] OK, so the bank's special responsibility.
[AGENT][NEUTRAL] I'm sorry?
[AGENT][NEUTRAL] Um, we don't determine patient responsibility because we're secondary.
[AGENT][NEUTRAL] Or we're supplement so we we can't determine patient responsibility.
[CUSTOMER][NEUTRAL] Yeah, so the balance amount is patient responsibility, right?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] We can't determine patient responsibility because we're a supplemental policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, got it.
[CUSTOMER][NEUTRAL] Can I get a copy of you, please?
[AGENT][NEUTRAL] What's the fax number?
[CUSTOMER][NEUTRAL] Yeah, it's [PII].
[AGENT][NEUTRAL] OK, is there anything else I can help with today?
[CUSTOMER][NEUTRAL] Uh, OK. I do have the rooms for the same number.
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and what's that date of service?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] It's for [PII].
[CUSTOMER][NEUTRAL] And the amount is $476 even.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] I was received [PII] process [PII].
[AGENT][NEGATIVE] There's no no benefits covered for physician and patient charges.
[CUSTOMER][NEUTRAL] Mm probably.
[CUSTOMER][NEUTRAL] Mm, OK.
[CUSTOMER][NEUTRAL] Can I also get the U?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Or any other dates of service?
[CUSTOMER][NEUTRAL] Yeah, one more of.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It's [PII] and it's for $353 even.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] Uh it's not covered, inpatient physician visits are not covered. That was received on.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Same date [PII] process [PII].
[CUSTOMER][NEUTRAL] Can I also have the UB?
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And may I have the same number?
[AGENT][NEUTRAL] My number 355-0413.
[CUSTOMER][NEUTRAL] OK, for the previous service also, and this too.
[AGENT][NEUTRAL] 355-041-1.
[CUSTOMER][NEUTRAL] And for the initial claim,
[AGENT][NEUTRAL] 355-0408.
[CUSTOMER][POSITIVE] Yeah. Thank you so much. Will you spell out your name.
[AGENT][NEUTRAL] [PII], it's [PII]
[CUSTOMER][NEUTRAL] Thank you. Can I get the call reference number?
[AGENT][NEUTRAL] It's my name is [PII] and today's date.
[CUSTOMER][POSITIVE] Limited. Yeah, thank you so much for me. Have a good evening.
[AGENT][POSITIVE] Thank you for calling APL you as well.