AccountId: 011433970860
ContactId: 538e753d-2f04-497e-90ca-d902ef858a7b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 446649 ms
Total Talk Time (AGENT): 91399 ms
Total Talk Time (CUSTOMER): 132030 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/22/538e753d-2f04-497e-90ca-d902ef858a7b_20250422T19:13_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Bye.
[CUSTOMER][NEUTRAL] Hey, [PII]. Hello.
[AGENT][POSITIVE] Hi, how can I help?
[CUSTOMER][NEUTRAL] Um, [PII] decide calling provider's office to check on game status.
[AGENT][POSITIVE] Happy to check on a claim. What's the policy number?
[CUSTOMER][NEUTRAL] Mm, yeah, the.
[CUSTOMER][NEUTRAL] Policy number will be 01920754 M as in Mike L as in Lima 8.
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] Mm, yup. Patient name name is [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII], yeah. And the date of birth will be
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] A of service.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Yeah, the service here is uh [PII].
[AGENT][NEUTRAL] And the bill amount?
[CUSTOMER][NEUTRAL] The amount $237 even.
[AGENT][NEUTRAL] We did receive a claim for the state of service on [PII].
[AGENT][NEUTRAL] Claim was denied mhm.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And processed date.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Claim was denied, office visits are not covered under the member policy.
[CUSTOMER][NEUTRAL] Sorry, office visit not covered?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Mm, like, can, can you read me the, uh, uh, like the correct reason.
[AGENT][NEUTRAL] Office visits are not covered by the member's policy.
[CUSTOMER][NEUTRAL] Me's policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, the denied date will be.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Just give me a moment, please.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, give me a moment, bear with me. Uh, I'm looking for some information.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Uh, do you have the claim number?
[AGENT][NEUTRAL] Yup, let me know when you're ready.
[CUSTOMER][NEUTRAL] Yep.
[AGENT][NEUTRAL] 356.
[AGENT][NEUTRAL] 1513.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 3561513
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, give me a moment. My number is.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK. Give me a moment, please bear with me. I'll be in a minute.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Please hold.
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah. Can you help me with the policy name? What was the policy name?
[AGENT][NEUTRAL] For the member's secondary insurance, this is a medling plan.
[CUSTOMER][NEUTRAL] Secondary insurance?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Medlink
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Can you spell that for me?
[AGENT][NEUTRAL] M as in Mary, E as in Echo, D as in Delta, L as in Lima, I as in India, N as in Nancy, K as in Kilo.
[CUSTOMER][NEUTRAL] OK, Medlink. OK.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Uh, can you send me like what is not covered, the provider or the service, like the
[AGENT][NEUTRAL] The office visit is not covered. The office visit fee is not covered under the member plan.
[CUSTOMER][NEUTRAL] Office visit fee.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Policy name, secondary insurance, that is Min, correct? OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, can you give me the conference number meanwhile?
[AGENT][NEUTRAL] Call references my name with my last initial than today's date. My name is [PII], that is spelled [PII]
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] Last initial
[CUSTOMER][NEUTRAL] Sorry, [PII]
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Initials my last name is [PII].
[CUSTOMER][NEUTRAL] Is it [PII]?
[AGENT][NEUTRAL] Yes, yes.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII] or single [PII]?
[AGENT][NEUTRAL] On our
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Yeah, thank you so much for that. You have a great day.
[AGENT][NEUTRAL] You too bye bye.
[CUSTOMER][POSITIVE] Take care. Bye-bye.