AccountId: 011433970860
ContactId: 54fad715-1f29-47be-8c97-4facbc5537fd
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 411160 ms
Total Talk Time (AGENT): 90350 ms
Total Talk Time (CUSTOMER): 143773 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/20/54fad715-1f29-47be-8c97-4facbc5537fd_20250220T16:55_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hello, my name is [PII]. I'm calling to check on claim status.
[AGENT][NEUTRAL] OK, I can verify claim status for you, [PII]. And what is the policy number, please?
[CUSTOMER][NEUTRAL] It's 02349126.
[AGENT][NEUTRAL] OK, thank you. One moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] Under
[CUSTOMER][NEUTRAL] Yeah. It is [PII]. It's the direct number.
[AGENT][NEUTRAL] OK, and verify the patient's name, date of birth.
[CUSTOMER][NEUTRAL] All right, it's under [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and what was the date of service and amount of the charge?
[CUSTOMER][NEUTRAL] OK, I have 3 claims for the same patient on a previous call. Uh, the lady told me that uh, office visits were not covered under patient policy, but let's confirm if this patient it's gonna be the same thing. I have the first date of service was on [PII] for $224 even.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] And what was your name again?
[AGENT][NEUTRAL] Uh, my name is [PII], last initial [PII], and you're calling from?
[CUSTOMER][NEUTRAL] Uh, art and health.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK, yes. Well, this one shows.
[CUSTOMER][NEUTRAL] It.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] So.
[AGENT][NEUTRAL] And you say you're calling from again?
[CUSTOMER][NEUTRAL] Yeah, well, the facility.
[CUSTOMER][NEUTRAL] Beautica Park Clinic.
[AGENT][NEUTRAL] And what's
[AGENT][NEUTRAL] Oh, give me one moment.
[AGENT][NEUTRAL] And what was the physician's name?
[CUSTOMER][NEUTRAL] It's um
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Nothing
[AGENT][NEUTRAL] OK. I'm showing that claim processes office visits are not covered per the policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, so I have the next claims for this patient, uh, depending date of services, um, but that they are gonna be the same, but we can confirm just for the records, OK?
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Right. Next day of service was on [PII] for 158.
[AGENT][NEUTRAL] OK, let's see.
[AGENT][NEUTRAL] OK, I'm sure that claim also processes, office visits are not covered.
[CUSTOMER][NEUTRAL] All right. And let's check the last one. It was on [PII].
[CUSTOMER][NEUTRAL] For the same billed amount, 158.
[AGENT][NEUTRAL] And, and that claim also processes office visits are not covered for the policy.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] No problem. Um, I do have another patient if you can assist me, so just to verify if this is gonna be the same thing for this patient.
[AGENT][NEUTRAL] OK, give me one moment type in this note.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm. All right.
[AGENT][NEUTRAL] OK, and what is that policy number?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] For this patient, it is.
[CUSTOMER][NEUTRAL] 01568766
[CUSTOMER][NEUTRAL] Under the name of [PII].
[CUSTOMER][NEUTRAL] The date of birth?
[CUSTOMER][NEUTRAL] [PII], sorry, [PII].
[AGENT][NEUTRAL] OK, and the data service amount of the charge?
[CUSTOMER][NEUTRAL] No, first date of service, it was on [PII] for 158.
[AGENT][NEUTRAL] Uh, that claim processes service rendered after policy terminated, uh, policy terminated on [PII].
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Give me a second.
[CUSTOMER][NEUTRAL] Alright, yeah, so, um, I believe there are other claims are gonna be the same thing. No problem, um, I think I have everything what I need now, mm.
[CUSTOMER][NEUTRAL] And well, just the, the call reference number and that's all.
[AGENT][NEUTRAL] Uh, we don't give reference numbers. If you like, you may use my name at today's date.
[CUSTOMER][POSITIVE] Got it, got it. No problem. All right. Well, thank you so much for your help, [PII]. Have a nice one.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] You're welcome. You too. Thanks for calling [PII]. Bye.
[CUSTOMER][NEUTRAL] Mhm. Bye-bye.