AccountId: 011433970860
ContactId: 66c7534f-3472-4c26-a823-d928c953d102
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 335929 ms
Total Talk Time (AGENT): 104115 ms
Total Talk Time (CUSTOMER): 97358 ms
Interruptions: 2
Overall Sentiment: AGENT=0.4, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/10/66c7534f-3472-4c26-a823-d928c953d102_20250110T20:59_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][POSITIVE] Hello sorry, thank you so much. This is [PII] for Romeo. I'm trying to check uh claim status, please.
[AGENT][NEUTRAL] OK [PII], I can help you with claim status. Can you please give me.
[AGENT][NEUTRAL] Call back number just in case our call gets disconnected.
[CUSTOMER][NEUTRAL] Sure. It is [PII].
[AGENT][NEUTRAL] Thank you, Ms. [PII]. And what is the patient's name?
[CUSTOMER][NEUTRAL] Uh, patient's ID is [PII].
[CUSTOMER][NEUTRAL] This one is for
[AGENT][POSITIVE] Thank
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, and what's the date of birth for the patient?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] A chance.
[AGENT][NEUTRAL] OK and then what is the data service?
[CUSTOMER][NEUTRAL] Um, the, the date of service is for [PII].
[AGENT][NEUTRAL] And what is the charge amount?
[CUSTOMER][NEUTRAL] $626.48.
[AGENT][NEUTRAL] Thank you. And then what's the charge amount?
[CUSTOMER][NEUTRAL] No, sorry, it's 40 cents.
[AGENT][NEUTRAL] OK, that's fine. What is the charge amount after the primary insurance paid their part?
[CUSTOMER][NEUTRAL] OK. Let me see. Well, I see that it was a part of the deductible and the patient, well, the responsibility was for.
[CUSTOMER][NEUTRAL] $356.13.
[AGENT][NEUTRAL] OK thank you and then what is the name of the facility that you're calling for Miss [PII]?
[CUSTOMER][NEUTRAL] Sam B P L O C.
[AGENT][NEUTRAL] And that's SAN how do I spell the first name?
[CUSTOMER][NEUTRAL] Yes, S A M B.
[CUSTOMER][NEUTRAL] B LLC.
[AGENT][NEUTRAL] OK, alright, I'm going to put you on a brief hold while I look up that claim for you and I will be right back.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK Ms. [PII], this is Tory back with you. I've got the claim pulled up and the claim number is 354-032-7.
[AGENT][NEUTRAL] The claim was denied because office visits are not covered under the policy.
[CUSTOMER][NEUTRAL] Sorry, can you repeat the denial reason again?
[AGENT][NEUTRAL] Office visits are not covered under the policy.
[CUSTOMER][NEUTRAL] OK, so, uh, do you only cover preventive services or something like that?
[AGENT][NEUTRAL] No, ma'am, um, this is just to verify benefits. It's not a guarantee of payment. What this policy help is deductible, co-pay, or co-insurance.
[AGENT][NEUTRAL] And under the outpatient benefit office visits are not covered.
[CUSTOMER][NEUTRAL] OK, so
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, that's perfect then. Thank you so much for your, for your help. May I have a reference number for this call, please?
[AGENT][NEUTRAL] Yes ma'am, you can use my name and today's date.
[CUSTOMER][POSITIVE] Awesome. Thank you so much again for your time.
[AGENT][NEUTRAL] It's [PII]
[AGENT][POSITIVE] You're so welcome, Ms. [PII]. I hope you have a good weekend. Thank you for calling APL Ms. [PII].
[CUSTOMER][POSITIVE] Perfect. Thank you so much.
[CUSTOMER][POSITIVE] Thank you. You too. Take care. Bye-bye.
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] Bye-bye, ma'am.