AccountId: 011433970860
ContactId: 4111570c-fd71-439c-a1ac-ebd1b0e0e011
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 220600 ms
Total Talk Time (AGENT): 86210 ms
Total Talk Time (CUSTOMER): 94390 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/21/4111570c-fd71-439c-a1ac-ebd1b0e0e011_20250521T16:29_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from products office. Uh, just reach out to you guys to check with the status of claim.
[AGENT][NEUTRAL] OK, I can verify claim status for you, [PII], and what is the policy number, please?
[CUSTOMER][POSITIVE] Thank you so much. So, the uh the policy number is 0254.
[CUSTOMER][NEUTRAL] 5740.
[AGENT][NEUTRAL] Thank you and do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] Yes. It's [PII].
[AGENT][NEUTRAL] And the patient's name, date of birth?
[CUSTOMER][NEUTRAL] It's uh [PII] [PII].
[AGENT][NEUTRAL] Thank you and what was the date of service and amount of the charge?
[CUSTOMER][NEUTRAL] It's uh [PII] of $25 charge amount would be $260 even.
[AGENT][NEUTRAL] And the balance after primary?
[CUSTOMER][NEUTRAL] OK, the balance of the primary is 9465.
[CUSTOMER][NEUTRAL] I mean $94. 65 cents.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] And while I'm looking at claim information, let you know we do have an online service center where providers can check claim status as well as print out the EOB. That site is at [PII]. And you're calling from?
[CUSTOMER][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] DS iles DBMP.
[AGENT][NEUTRAL] Yes
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] I.
[AGENT][NEUTRAL] I'm showing the claim processes service is not covered when performed in a doctor's office or clinic.
[CUSTOMER][NEUTRAL] OK, uh, one moment here. I'd like to know when it was got denied. What's the denial date?
[AGENT][NEUTRAL] Uh, the claim was processed on [PII].
[CUSTOMER][NEUTRAL] [PII] and they know the same date right stating that services are not.
[CUSTOMER][NEUTRAL] Covered when performed in office.
[AGENT][NEUTRAL] When
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, and for an outpatient office visit. But even the surgeries or procedures will not covered if they are done in the POS 1.
[AGENT][NEUTRAL] Correct, it's not covered. Policy only covers services outpatient or in hospital. uh, procedures in office is not covered.
[CUSTOMER][NEUTRAL] Office.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, but then it's not covered. Got it. OK I have the claim number?
[AGENT][NEUTRAL] Sure, uh, the claim number is 3594412.
[CUSTOMER][NEUTRAL] 3594412. OK and then what's the patient's plan name? Can I have the name please?
[AGENT][NEUTRAL] Medlink, [PII]
[CUSTOMER][NEUTRAL] Med link.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, just planning is just bedlink.
[AGENT][NEUTRAL] Correct, that's the name of the plan Medlink.
[CUSTOMER][POSITIVE] OK. Got it then. Yup, uh, thank you so much for assistance. May I have your name and spelling of your name, please?
[AGENT][NEUTRAL] It's [PII], last [PII] [PII].
[CUSTOMER][NEUTRAL] OK, and the card number [PII].
[AGENT][NEUTRAL] Uh, you may use my name in today's date, and [PII], is there anything else I can assist you with today?
[CUSTOMER][POSITIVE] No, that's thank you so much for since regarding it. Thank you so much and have a wonderful day. Bye for now.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] You're welcome. Thanks for calling APL bye.
[CUSTOMER][NEUTRAL] Bye.