AccountId: 011433970860
ContactId: 4cec7969-f0aa-4bb6-8805-df6784d8a1d5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 214669 ms
Total Talk Time (AGENT): 70479 ms
Total Talk Time (CUSTOMER): 63094 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/12/4cec7969-f0aa-4bb6-8805-df6784d8a1d5_20250312T21:26_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh, hi. My name is [PII]. I'm calling from provider's office for claim status.
[AGENT][NEUTRAL] OK, [PII], I'm happy to check on claim status for you today. May I please have the patient's policy number?
[CUSTOMER][NEUTRAL] Uh yes, it is.
[CUSTOMER][NEUTRAL] 02218491.
[AGENT][POSITIVE] All right. Thank you. One moment.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] May I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] It is [PII]. Date of birth, [PII].
[AGENT][NEUTRAL] OK, thank you for that. And then what's the date of service?
[CUSTOMER][NEUTRAL] Yeah, it's for [PII] [PII], uh with the bill amount, $258.96.
[AGENT][NEUTRAL] And you said [PII]?
[CUSTOMER][NEUTRAL] Uh, no, it is [PII].
[AGENT][NEUTRAL] [PII], OK.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, so thank you for your patience on that, [PII]. So it looks like we did receive a claim for the state of service. claim was received on [PII].
[AGENT][NEUTRAL] Claim was denied, office visits are not covered under the member's policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so based on the patient's plan offers did not.
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] And also the, sorry, may I know the bill amount uh that is applied to the patient responsibility?
[AGENT][NEUTRAL] We're not able to advise on patient responsibility, that would be up to the facility or the provider.
[CUSTOMER][POSITIVE] OK. Sure. Thank you for this information.
[CUSTOMER][NEUTRAL] Claim number
[AGENT][NEUTRAL] Uh, claim number would be 355.
[AGENT][NEUTRAL] 0072.
[CUSTOMER][NEUTRAL] 5
[CUSTOMER][NEUTRAL] That's 2
[CUSTOMER][NEUTRAL] OK, thank you. And that's all for today. May I know the call reference number, please?
[AGENT][NEUTRAL] Call reference is going to be my name with my last initial and then today's date. My name again is [PII], that's [PII]
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] State
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Last initial is [PII].
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][POSITIVE] OK. Thank you for your assistance and have a wonderful day.
[AGENT][NEUTRAL] You too bye bye.
[CUSTOMER][NEUTRAL] Bye-bye.