AccountId: 011433970860
ContactId: 67cb4234-835a-4a29-8c3b-998b06c1d77e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 200529 ms
Total Talk Time (AGENT): 40317 ms
Total Talk Time (CUSTOMER): 79548 ms
Interruptions: 0
Overall Sentiment: AGENT=1.2, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/25/67cb4234-835a-4a29-8c3b-998b06c1d77e_20250625T15:12_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yeah. Hi, [PII]. This is [PII] speaking from provider's office. Could you help me with checking on a claim status?
[AGENT][NEUTRAL] Yes, I can help you with claim status, [PII]. Do you have a good callback number?
[CUSTOMER][NEUTRAL] Yeah, it's [PII].
[AGENT][NEUTRAL] OK, do you have a policy number for the patient?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] The member ID number is 02566961.
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] My name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] The date of service and bill charges?
[CUSTOMER][NEUTRAL] D of service is [PII] total charge.
[CUSTOMER][NEUTRAL] $23. I'm sorry, it's $46 even.
[AGENT][NEUTRAL] OK. Uh, give me one moment.
[CUSTOMER][NEUTRAL] Mhm OK.
[AGENT][NEUTRAL] It was received on 127 25.
[AGENT][NEUTRAL] Oh it's 128 25.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Uh, policy provides no benefit for charges made by a doctor for inpatient visits.
[CUSTOMER][NEUTRAL] Oh, OK. Could you repeat that one more time?
[AGENT][NEUTRAL] Uh, policy does not pay for inpatient doctor visits.
[CUSTOMER][NEUTRAL] OK, or you don't not make payments for inpatient, uh, doctors, is it right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, just a second.
[CUSTOMER][NEUTRAL] So it's as per the member's policy, right? Or insurance policy, OK, OK.
[AGENT][POSITIVE] Yes, correct.
[CUSTOMER][NEUTRAL] Inpatient, yeah, I place our service is inpatient.
[CUSTOMER][NEUTRAL] Just a second.
[CUSTOMER][NEUTRAL] So you guys won't cover the claim if the patient is uh if the claim was submitted to the inpatient, right? If the patient is inpatient means you guys won't pay, right?
[AGENT][POSITIVE] Correct, for physician charges, yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] In this case we need to build the patient for this, right?
[AGENT][NEUTRAL] Uh, we can't instruct on patient responsibility, whereas supplemental policy.
[CUSTOMER][NEUTRAL] OK, sure. And thanks for confirming me that. Can I get the call reference number?
[AGENT][NEUTRAL] My name is [PII], and today's date.
[CUSTOMER][POSITIVE] OK, [PII]. So thank you for calling me today and that's all.
[AGENT][POSITIVE] OK, thanks for calling APL. Have a great day.
[CUSTOMER][POSITIVE] Yeah you too bye bye.