AccountId: 011433970860
ContactId: 5fd4b64c-2a3f-4d73-9d38-477fc1cb12c2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 220820 ms
Total Talk Time (AGENT): 71068 ms
Total Talk Time (CUSTOMER): 62486 ms
Interruptions: 0
Overall Sentiment: AGENT=1.8, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/21/5fd4b64c-2a3f-4d73-9d38-477fc1cb12c2_20250321T18:58_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Uh, this is calling for the provider to check on additional information about a claim that has been denied. Please know this call will be monitored and recorded for quality and training purposes. Hello.
[AGENT][NEUTRAL] And, and may I have your name one more time? I didn't get your name.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you. And you're calling from which facility for my notation? May I have the name of the facility?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yes, uh, the facility name is AIDS Healthcare Foundation.
[AGENT][NEUTRAL] And may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII], direct line.
[CUSTOMER][NEUTRAL] But
[AGENT][NEUTRAL] OK, may I have the patient's policy number?
[CUSTOMER][NEUTRAL] 02559255
[AGENT][POSITIVE] Thank you. One moment.
[CUSTOMER][POSITIVE] nice.
[AGENT][NEUTRAL] What's the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][POSITIVE] OK. Thank you.
[AGENT][NEUTRAL] And what is the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] [PII] $266.34.
[AGENT][NEUTRAL] OK, that was [PII], correct?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] That's like the
[CUSTOMER][NEUTRAL] 2025
[AGENT][NEUTRAL] All right, it looks like we have um received a claim on [PII], processed on [PII], and the claim was denied. The denial reason is office visits are not covered by the policy.
[CUSTOMER][NEUTRAL] No
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] One moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Thank you for holding. So and what's your policy name or the plan name?
[AGENT][NEUTRAL] This is one of our secondary supplemental plan to the major medical.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Is there a supplement plan type?
[AGENT][NEUTRAL] No, because this is secondary to the major medical.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Thank you. May I have the call reference number?
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in today's date if you will.
[CUSTOMER][POSITIVE] Thank you. Thank you, sir. Have a wonderful day.
[AGENT][POSITIVE] You're welcome. You as well. Thank you for calling APL. Bye-bye.