AccountId: 011433970860
ContactId: 4906389c-2fed-4092-8db3-3ca50f1ca5e7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 318959 ms
Total Talk Time (AGENT): 110725 ms
Total Talk Time (CUSTOMER): 159644 ms
Interruptions: 1
Overall Sentiment: AGENT=0.4, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/22/4906389c-2fed-4092-8db3-3ca50f1ca5e7_20250122T13:22_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling UPL. This is [PII] how [PII]
[CUSTOMER][POSITIVE] Hey, [PII], very good morning. How are you?
[AGENT][POSITIVE] I'm good. How are you?
[CUSTOMER][POSITIVE] Yeah, I'm good. Thank you so much for asking. Uh, uh, this is [PII] calling from Flo's office to check on a claim information.
[AGENT][NEUTRAL] You're checking claim status?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, if I can get the policy number?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah, that's good. The policy number starts with the
[CUSTOMER][NEUTRAL] 02120049 Mike Lima number 8.
[AGENT][NEUTRAL] OK, what's a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] It's [PII]. It's a direct line.
[AGENT][NEUTRAL] OK. [PII].
[CUSTOMER][NEUTRAL] And.
[CUSTOMER][NEUTRAL] [PII], [PII] it's a.
[AGENT][NEUTRAL] OK, 952. And what's the patient's name and date of birth?
[CUSTOMER][POSITIVE] Yeah, yeah, that's good.
[CUSTOMER][NEUTRAL] Yeah, yeah, and the patient name on file it as a
[CUSTOMER][NEUTRAL] It's [PII]
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you. And you said that you're checking a claim status?
[CUSTOMER][NEUTRAL] Yeah, client status.
[AGENT][NEUTRAL] OK, we can help you with that information. What's the date of service?
[CUSTOMER][NEUTRAL] Yeah, it's uh [PII] with build amount. It's just $6 even.
[AGENT][NEUTRAL] You said $6?
[CUSTOMER][NEUTRAL] Yeah, $6 even.
[CUSTOMER][NEUTRAL] I have put the records of the phone number. This is my case.
[CUSTOMER][NEUTRAL] s
[CUSTOMER][NEUTRAL] So this is for the service render on uh [PII].
[AGENT][NEUTRAL] Can you show the claim was received [PII]. Process date [PII], it denied. Under this policy, treatment.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And the office is not covered, so there was no payment made?
[CUSTOMER][NEUTRAL] Comegana.
[AGENT][NEUTRAL] Let me know when you
[CUSTOMER][NEUTRAL] Can I get the reason once again?
[AGENT][NEUTRAL] Treatment, the vine puncture is not covered under the patient's policy. Treatment in a doctor's office is not covered.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] OK, not covered as per person. OK, OK, one second, not covered as.
[AGENT][NEUTRAL] Let me know when you're ready for the.
[AGENT][NEUTRAL] Patient's policy.
[AGENT][NEUTRAL] For patients policy?
[CUSTOMER][NEUTRAL] Well
[CUSTOMER][NEUTRAL] Once again. Can I get the patient's policy name?
[CUSTOMER][NEUTRAL] You.
[AGENT][NEUTRAL] The supplemental gap plan.
[CUSTOMER][NEGATIVE] Sorry, come again.
[AGENT][NEUTRAL] A supplemental Met link gap policy.
[CUSTOMER][POSITIVE] Good is followed.
[AGENT][NEUTRAL] M E D L I N K, a Metlink policy.
[CUSTOMER][NEUTRAL] M E D L I
[CUSTOMER][NEUTRAL] And you right.
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] Let me know what
[CUSTOMER][NEUTRAL] And is it HMO or one second. It is HMO or give you like this.
[AGENT][NEUTRAL] It's a supplemental policy, neither, neither. It's secondary to the major medical. Let me know when you're ready for the claim number.
[CUSTOMER][NEUTRAL] Supplement
[CUSTOMER][POSITIVE] Yeah, I'm ready.
[AGENT][NEUTRAL] That number is 354.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] 7798.
[AGENT][NEUTRAL] And you can also check claim status on the online service center at [PII], and did you have any other questions?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah, can I build the patient?
[AGENT][NEUTRAL] We cannot advise, we do not determine patients responsibility.
[CUSTOMER][NEUTRAL] OK. And once again, the member's plan type, it is a supplemental meddling policy, right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Any other questions?
[CUSTOMER][NEUTRAL] Yeah, one second and could you spell out, it is M E D I L I N K, right?
[AGENT][NEUTRAL] M E D L I N K Med and then link.
[CUSTOMER][NEUTRAL] M E D L I N K, right? Medlink.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Madling policy supplement.
[CUSTOMER][NEUTRAL] Once again, the policy name is supplements meddling Policy.
[AGENT][NEUTRAL] Correct. Did you?
[CUSTOMER][NEUTRAL] Can I get a card that organization?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] You'll use my name in today's date as your reference, [PII].
[AGENT][NEUTRAL] Oh NYA.
[AGENT][NEUTRAL] First initial last name is [PII].
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] All righty. Anything else?
[CUSTOMER][NEUTRAL] No have been done.
[AGENT][POSITIVE] All right, thanks for calling APL Tom have a good day.
[CUSTOMER][NEUTRAL] You too. Bye-bye.
[AGENT][NEUTRAL] Bye bye.