AccountId: 011433970860
ContactId: 5fba2af4-f5bb-45f7-a88d-24999ec4ceff
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 355709 ms
Total Talk Time (AGENT): 106871 ms
Total Talk Time (CUSTOMER): 153348 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/20/5fba2af4-f5bb-45f7-a88d-24999ec4ceff_20250520T18:00_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Hi, this is [PII]. I'm calling on behalf of facility to check on the claim status.
[AGENT][NEUTRAL] I'm sure I can assist you with claim status. Um, first, could I get your name again and a good callback number?
[CUSTOMER][NEUTRAL] My name is [PII]. It's [PII]. Last name is, my name is [PII]. Callback number is [PII] with an extension of [PII].
[CUSTOMER][NEUTRAL] And this.
[AGENT][NEUTRAL] OK. Thank you, and I need the policy number, please.
[CUSTOMER][NEUTRAL] 16
[CUSTOMER][NEUTRAL] 024967887.
[CUSTOMER][NEUTRAL] On
[AGENT][NEUTRAL] And please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] You know
[CUSTOMER][NEUTRAL] Yeah. Member's name is [PII] and date of birth is [PII].
[AGENT][NEUTRAL] Thank you. Now I need the date of service and bill charges on the claim.
[CUSTOMER][NEUTRAL] Date of service is [PII] with the total charges of $348 even.
[AGENT][NEUTRAL] OK, thank you. I'm showing that we
[CUSTOMER][NEUTRAL] Could you please spell me your name?
[AGENT][NEUTRAL] Um, it's spelled [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Thank you so much, yeah, please go ahead.
[AGENT][NEUTRAL] OK. Um, we received the claim on [PII].
[AGENT][NEUTRAL] The claim processed on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The claim number is
[AGENT][NEUTRAL] 359-1012.
[CUSTOMER][NEUTRAL] 650.
[CUSTOMER][NEUTRAL] 003.
[AGENT][NEUTRAL] And the claim denied because office visits are not covered under the policy.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] I do.
[CUSTOMER][NEUTRAL] So these visits are not covered under the member's benefit plan, right?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] May I know the member's plan type?
[AGENT][NEUTRAL] Medlink, [PII]
[CUSTOMER][NEUTRAL] Medlink
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] OK, one moment here. Just a moment.
[CUSTOMER][NEGATIVE] It's not.
[CUSTOMER][NEUTRAL] No
[CUSTOMER][NEUTRAL] Could you please uh fax me the copy of COB?
[CUSTOMER][NEUTRAL] 856 4.
[AGENT][NEUTRAL] Yes, what's your fax number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK. That's [PII].
[CUSTOMER][NEUTRAL] To
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Yes, and uh is this will it be the member's responsibility?
[CUSTOMER][NEUTRAL] 5.
[AGENT][NEUTRAL] Yes, it will be.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] May I know when they will be received?
[CUSTOMER][NEUTRAL] What is the tax time around time?
[AGENT][NEUTRAL] Um, yes, she
[AGENT][POSITIVE] Yes, you should receive it in about 10 minutes. Is there anything else I can assist you with?
[CUSTOMER][NEUTRAL] Uh, I do have one more data service for the same number. Could you please assist me with that as well?
[AGENT][NEUTRAL] Um, yes. What's the date of service, please?
[CUSTOMER][NEUTRAL] Just a moment here.
[CUSTOMER][NEUTRAL] Yes, uh, next date of service is [PII] with the total charges of $348 even.
[CUSTOMER][NEUTRAL] It's
[AGENT][NEUTRAL] OK, yes, sir. We received that claim on [PII].
[AGENT][NEUTRAL] The claim processed on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The claim number is 360.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 253 7.
[AGENT][NEUTRAL] And this claim also denied um because office visits are not covered under the patient's plan.
[CUSTOMER][NEUTRAL] Just a moment.
[CUSTOMER][NEUTRAL] One moment here.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Yeah, uh, could you find this one as well, please fax me the copy of your.
[AGENT][NEUTRAL] Um, yes, and again, that fax number is [PII]. Attention and.
[CUSTOMER][NEUTRAL] Yes. May I have the call reference number?
[AGENT][NEUTRAL] Yes, the reference number is my name and today's date. Um, is there anything else I can assist you with?
[CUSTOMER][POSITIVE] No, thank you so much for all the information. Hope you have a great day and stay safe.
[AGENT][NEUTRAL] You do the same, man. Thank you for calling APL um bye.
[CUSTOMER][NEUTRAL] Yeah.