AccountId: 011433970860
ContactId: 60c7dcfe-e6fd-4eba-82bf-9636fdc8741e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 218210 ms
Total Talk Time (AGENT): 93723 ms
Total Talk Time (CUSTOMER): 70990 ms
Interruptions: 1
Overall Sentiment: AGENT=1, CUSTOMER=1.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/11/60c7dcfe-e6fd-4eba-82bf-9636fdc8741e_20250411T18:34_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] I'm sorry, I didn't catch your name.
[AGENT][NEUTRAL] My name is [PII].
[CUSTOMER][NEUTRAL] OK sorry I broke up when you said that. Hi, so my name is [PII]. um I'm calling in regards to check um some information on a claim for our patient.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] OK, sure, I can assist you with claims Miss [PII]. May I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Mhm [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] It is 015.
[CUSTOMER][NEUTRAL] 26961.
[AGENT][NEUTRAL] Thank you. And may I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] It is [PII] and date of birth is [PII].
[AGENT][NEUTRAL] OK, perfect, thank you. What is the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] It was [PII] and the bill amount was $65.
[AGENT][NEUTRAL] OK, let me see if I can find this claim, and that was [PII], correct?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK, so it looks like it has processed twice. I'm gonna give you the original claim. The most recent one was denied as a duplicate, OK.
[AGENT][NEUTRAL] Bear with me.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] I'm still waiting on the system.
[CUSTOMER][POSITIVE] Not a problem.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so it looks like we processed the claim on [PII] and the claim was denied. The reason for the denial is that DME or dual medical equipment is not covered under this policy.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Right, is that patient responsibility?
[AGENT][NEUTRAL] Um, it's gonna be up to the provider's discretion. We don't have any contractual involvement because this is just a limited policy. We don't know if he has any other policies out there.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, got you.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm. Do you need the claim number?
[CUSTOMER][NEUTRAL] Um, is it 349-035-4?
[AGENT][POSITIVE] Yes, that is correct. Mhm.
[CUSTOMER][NEUTRAL] OK, OK, that's, well, originally what I was calling for to see if it was um patient responsibility, so that's why.
[AGENT][NEUTRAL] Um, all right. So it's up to the provider's discretion.
[CUSTOMER][POSITIVE] OK, wonderful.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK wonderful thank you so is there a reference number for this call?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in today's date if you would like, Miss [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, that will work. I will do that thank you I appreciate your help today.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] You're welcome and thank you for calling APL. Have a good afternoon. Happy weekend.
[CUSTOMER][POSITIVE] You too thank you.
[AGENT][POSITIVE] Thank you. You're welcome bye bye.
[CUSTOMER][NEUTRAL] Mm bye.