AccountId: 011433970860
ContactId: 45e965f3-e898-42a2-a7a9-48a2e3bd7b92
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 259910 ms
Total Talk Time (AGENT): 106522 ms
Total Talk Time (CUSTOMER): 103860 ms
Interruptions: 1
Overall Sentiment: AGENT=1.1, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/28/45e965f3-e898-42a2-a7a9-48a2e3bd7b92_20250228T18:26_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling this is speaking.
[CUSTOMER][NEUTRAL] Probably.
[CUSTOMER][NEUTRAL] Hi, I'm [PII] calling from provider's office regarding our claims.
[AGENT][NEUTRAL] OK, I can verify claim status for you and [PII], what is that policy number, please?
[CUSTOMER][NEUTRAL] Uh yeah, sure. Uh, policy number is 02175445 M as in Mike L as in Lima 8.
[AGENT][POSITIVE] OK, thank you. Give me one moment, please.
[AGENT][NEUTRAL] OK, thank you. And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] Sure, the callback number is [PII] with an extension of [PII].
[AGENT][NEUTRAL] OK, and verify the patient's name, date of birth.
[CUSTOMER][NEUTRAL] Sure, ma'am's first name is uh
[CUSTOMER][NEUTRAL] [PII]. And the last name is [PII].
[CUSTOMER][NEUTRAL] I.
[AGENT][NEUTRAL] Date of birth?
[CUSTOMER][NEUTRAL] Yes. Date of birth is [PII].
[AGENT][NEUTRAL] OK, and what was the date of service and the amount of the charge?
[CUSTOMER][NEUTRAL] Uh, the date of service is, uh, [PII].
[CUSTOMER][NEUTRAL] [PII] with the bill amount of $2237 even.
[AGENT][NEUTRAL] OK, and the balance after primary insurance has processed the claim?
[CUSTOMER][NEUTRAL] Uh, $65 even.
[AGENT][NEUTRAL] You said $65?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, and while I'm looking up claim information, just to let you know we do have an online service center where providers can check claim status as well as print out the ELB. That site is at secured. M [PII].
[AGENT][NEUTRAL] And you are calling from?
[CUSTOMER][NEUTRAL] I'm calling from uh
[CUSTOMER][NEUTRAL] Providers of gastro.
[AGENT][NEUTRAL] OK, I show that claim process as office visits are not covered per the policy.
[CUSTOMER][POSITIVE] I like to see.
[CUSTOMER][NEUTRAL] OK, you're stating that um.
[CUSTOMER][NEUTRAL] Offices are not covered on the member's policy, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] May I know when did you receive the claim?
[AGENT][NEUTRAL] 01 moment.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Uh, claim received [PII], processed [PII].
[CUSTOMER][NEUTRAL] [PII] for it uh.
[CUSTOMER][NEUTRAL] Could you please help me in providing the uh members plan name?
[AGENT][NEUTRAL] Medlink.
[CUSTOMER][NEUTRAL] Meddling, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Really?
[CUSTOMER][NEUTRAL] Could you please like, uh, can you send me a copy of your, is it possible?
[AGENT][NEUTRAL] Sure, but as I stated, we do have an online service center where providers can check claim status as well as print out the EOB and that site is at secured. M [PII].
[AGENT][NEUTRAL] And [PII], what is the fax number?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, that's [PII].
[CUSTOMER][NEUTRAL] But.
[AGENT][NEUTRAL] And is there anything else I can assist you with today?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Could you please tell me the claim number and the call reference?
[AGENT][NEUTRAL] Uh, claim number 3549279, and we don't give call reference numbers, you may use my name in today's date.
[CUSTOMER][NEUTRAL] OK, you stated that the uh claim number is 354-9279. Am I right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Sure, uh, can you spell your name with the last name itself so for the documentation purposes, that's all the information I needed.
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] Sure, it's [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Thank you, [PII].
[AGENT][POSITIVE] You're welcome. Thank you for calling APL. Have a great day, [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, bye for now.
[AGENT][NEUTRAL] Mhm.