AccountId: 011433970860
ContactId: 4ade2612-078b-48c8-9c75-dcfc851603ae
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 327910 ms
Total Talk Time (AGENT): 99398 ms
Total Talk Time (CUSTOMER): 133931 ms
Interruptions: 1
Overall Sentiment: AGENT=0.7, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/14/4ade2612-078b-48c8-9c75-dcfc851603ae_20250114T16:17_UTC.wav
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[AGENT][NEUTRAL] Calling APL, my name is [PII]. How may I assist you today?
[CUSTOMER][NEUTRAL] Uh hello, [PII]. This is [PII] calling from the product office. Could you please help me with the claim, please?
[AGENT][POSITIVE] Um, I'd be happy to assist with the claim. Can you repeat your first name for me, please?
[CUSTOMER][NEUTRAL] Yes, my first name is [PII].
[AGENT][POSITIVE] At least if I can get a good call back number for you.
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And what is the, oh, I'm sorry.
[CUSTOMER][NEUTRAL] Uh there is an extension. It is [PII].
[AGENT][NEUTRAL] And what is the policy number?
[CUSTOMER][NEUTRAL] 02446791. M as in Mike, L as in Lima, and the number 8.
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] Uh yes. The patient name is.
[CUSTOMER][NEUTRAL] Uh, hi, [PII]. The date of birth is on [PII].
[AGENT][NEUTRAL] And what is the data of service?
[CUSTOMER][NEUTRAL] It is on [PII].
[CUSTOMER][NEUTRAL] And the bill amount is
[AGENT][NEUTRAL] I'm sorry, repeat that.
[CUSTOMER][NEUTRAL] Yes, it is [PII].
[CUSTOMER][NEUTRAL] And the bill amount is $200 even?
[AGENT][NEUTRAL] And what is your tax ID?
[CUSTOMER][NEUTRAL] Uh, yes, the tax ID is 330, 0 sorry, just a moment.
[CUSTOMER][NEUTRAL] Is it [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, I'm not showing we received that claim.
[CUSTOMER][NEUTRAL] Uh, I do have a claim number. Shall I provide the claim number?
[AGENT][NEUTRAL] What's the claim number?
[CUSTOMER][NEUTRAL] Yes, just a moment.
[CUSTOMER][NEUTRAL] Yes, the claim number it is.
[CUSTOMER][NEUTRAL] 354.
[CUSTOMER][NEUTRAL] 310
[AGENT][NEUTRAL] OK, that
[AGENT][NEUTRAL] Tax ID you gave me, is it not matching the tax ID that we have on that claim?
[CUSTOMER][NEUTRAL] OK, shall I provide the different one? I do have that one also.
[AGENT][NEUTRAL] OK, now I mean I have it pulled up now but when when I asked for the tax ID you gave me something different that's why I told you, well we don't have a claim on file.
[CUSTOMER][NEUTRAL] OK, so
[CUSTOMER][NEUTRAL] me
[CUSTOMER][NEUTRAL] Uh yes, ma'am, because we do have a different tool, that's why I got confused. Mhm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So how can I assist with this claim?
[CUSTOMER][NEUTRAL] Uh, yes, this claim was denied as durable medical equipment are not covered under the patient plan. But in the [PII] there was no any patient responsibility. May I know is there any patient responsibility for this claim?
[AGENT][NEUTRAL] We don't determine patient responsibility, so that that's something you would have to decide.
[CUSTOMER][NEUTRAL] OK. You said you will not mention that on file?
[AGENT][NEUTRAL] Um, I don't understand. We're not a primary insurance, we're the secondary. Patient responsibility can only be determined by the primary insurance.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, yes, the primary work uh process and uh uh transfer the balance to secondary.
[AGENT][NEUTRAL] Right, but durable medical equipment is not covered, so I guess.
[CUSTOMER][NEUTRAL] So mhm.
[AGENT][NEUTRAL] You have to charge the patient because that's not a covered benefit with our, our policy.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Mhm. OK. Thank you so much. And is there, may I know the patient responsibility, how much it is?
[AGENT][NEUTRAL] I, I don't know whatever you wanna charge them. We, we don't determine that.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Provide me a fax number uh for sending an a bill.
[AGENT][NEUTRAL] Mhm. It's [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] I'm sorry, what did you say?
[CUSTOMER][NEUTRAL] Uh, could you please repeat the fax number once again?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, [PII], right, you said?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Uh, thank you so much. And may I get your name, please?
[AGENT][NEUTRAL] It's [PII]. Last initial is [PII]. Was there anything else I could assist with today?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Nothing else. May I get a call reference number for the call?
[AGENT][NEUTRAL] Reference is just my name and today's date and time.
[CUSTOMER][POSITIVE] OK, thank you so much for the information and your time. Have a great day.
[AGENT][POSITIVE] Thank you for calling APL have a good day.
[CUSTOMER][NEUTRAL] Bye bye.