AccountId: 011433970860
ContactId: 65bda930-14f6-49b8-8409-fcd5d6de908a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 287019 ms
Total Talk Time (AGENT): 89651 ms
Total Talk Time (CUSTOMER): 98125 ms
Interruptions: 1
Overall Sentiment: AGENT=0.7, CUSTOMER=1.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/12/65bda930-14f6-49b8-8409-fcd5d6de908a_20250312T14:28_UTC.wav
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[AGENT][POSITIVE] Good morning. Thanks for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Yes, hi, this is [PII] calling from providers billing office. How are you doing today?
[AGENT][NEUTRAL] I am fine, and yourself?
[CUSTOMER][NEUTRAL] Oh, I'm good, thanks for asking. Before I proceed, these calls are being recorded for clarity and training purposes. Is this OK for you to be recorded?
[AGENT][NEUTRAL] Oh, that's fine.
[CUSTOMER][POSITIVE] Thank you so much for that. Yes, I'm looking for the claim status. Can you please help me out with that?
[AGENT][NEUTRAL] Yes, I can verify claim status for you and you say your name is [PII]?
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[AGENT][NEUTRAL] [PII], OK.
[AGENT][NEUTRAL] And what is the policy number, please?
[CUSTOMER][NEUTRAL] Yes, uh, the policy number starts with 148.
[CUSTOMER][NEUTRAL] 0322 ML 8.
[AGENT][NEUTRAL] OK, thank you. One moment.
[CUSTOMER][NEUTRAL] The
[CUSTOMER][NEUTRAL] Finance.
[AGENT][NEUTRAL] And verify the patient's name, date of birth.
[CUSTOMER][NEUTRAL] Uh, sorry for that.
[AGENT][NEUTRAL] Uh-huh, verify the patient's name, date of birth.
[CUSTOMER][NEUTRAL] Yes, uh, the patient's name.
[CUSTOMER][NEUTRAL] Uh, yes, the patient's name is [PII] with the date of birth [PII].
[AGENT][NEUTRAL] OK, thank you, ma'am. And what was the date of service and amount of the charge?
[CUSTOMER][NEUTRAL] Yes, the date of service is [PII] with the bill amount $600 even.
[AGENT][NEUTRAL] OK, thank you. And do you have the balance after primary has processed the claim?
[CUSTOMER][NEUTRAL] Oh just give me a moment. I'm checking it out.
[CUSTOMER][NEUTRAL] Yes, uh.
[CUSTOMER][NEUTRAL] I do see balance as
[CUSTOMER][NEUTRAL] $53.68.
[AGENT][NEUTRAL] OK. Well, I don't show a claim for uh that amount. Uh, can you verify the mailing address it was submitted to?
[CUSTOMER][NEUTRAL] OK. Uh, can you please, uh, cross-check with the bill bill amount $197 even.
[AGENT][NEUTRAL] So is it supposed to be 1600 or 197?
[CUSTOMER][NEUTRAL] 197.
[AGENT][NEUTRAL] OK. Uh, do show we received the claim for that amount and it processes office visits are not covered per the policy.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK. Is there anything else I can assist you with today?
[CUSTOMER][POSITIVE] OK, thank you so much. Yes, uh, is it the person responsibility?
[AGENT][NEUTRAL] We can give patient responsibility. We can only verify that the claim process is office visits are not covered.
[CUSTOMER][POSITIVE] OK, thank you so much for that. Uh, yes, can I have the withdrawal fax number, please?
[AGENT][NEUTRAL] Uh, we do have an online service center where providers can check claim status as well as print out the EOB. That site is at [PII].
[CUSTOMER][POSITIVE] Thank you so much for that, mm.
[CUSTOMER][NEUTRAL] Please give me a moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Oh yes, thank you so much. Can I have the claim number, please?
[AGENT][NEUTRAL] Sure, claim number 355-0770.
[CUSTOMER][NEUTRAL] Yes, it's 355-077-0. Am I right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] Thank you so much for that. Uh, yes, can I have the call reference number?
[AGENT][NEUTRAL] Uh, we don't give reference numbers. If you like, you may use my name in today's date.
[CUSTOMER][NEUTRAL] Uh, can I have your name please?
[AGENT][NEUTRAL] Sure, it's [PII].
[CUSTOMER][POSITIVE] Thank you so much for that. Uh, yes, that's it from my side. Thank you so much for helping. Have a nice day.
[AGENT][POSITIVE] Alright, you're welcome, [PII]. Thanks for calling APL. Bye.
[CUSTOMER][NEUTRAL] Bye bye.