AccountId: 011433970860
ContactId: 69c5bca5-26bb-4a73-8a5f-db481cee8c87
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 290510 ms
Total Talk Time (AGENT): 107420 ms
Total Talk Time (CUSTOMER): 36427 ms
Interruptions: 1
Overall Sentiment: AGENT=2.1, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/28/69c5bca5-26bb-4a73-8a5f-db481cee8c87_20250428T14:49_UTC.wav
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[AGENT][NEUTRAL] calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from provider's office to check on a claim status.
[AGENT][NEUTRAL] OK, [PII], you have one client.
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] And to check status on, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] How many claims, [PII], do you have to check status on?
[CUSTOMER][NEUTRAL] One time.
[AGENT][POSITIVE] Yes, I can help you with that. And what is your callback number, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you and the member's policy number, please.
[CUSTOMER][NEUTRAL] 018961
[CUSTOMER][NEUTRAL] 19
[AGENT][POSITIVE] Thank you one moment please.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] And any information now that I do provide for you today would be a verification of benefits and not a guarantee of payment. What is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And the date of service and total bill amount.
[CUSTOMER][NEUTRAL] [PII] $125 even.
[AGENT][NEUTRAL] Did you say the year is [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And what was the billed amount?
[CUSTOMER][NEUTRAL] $125 even.
[AGENT][POSITIVE] Thank you. One moment.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] OK, so you said the bill amount is $125 now then, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, I do not have a claim on file for this member. Uh, well, wait, just, just one moment please. I'm sorry, one moment.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, so um for that claim, the claim number is 34832229.
[AGENT][NEUTRAL] And it does show that.
[AGENT][NEUTRAL] For that bill amount.
[AGENT][NEGATIVE] That was denied. Give me just a moment to look at the remark.
[AGENT][NEUTRAL] OK, so that code was denied, the $125 charge was denied for a limited to one X-ray procedure for 5-year period.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So um
[CUSTOMER][NEUTRAL] Sorry, could you please repeat it?
[AGENT][NEUTRAL] Limited to one X-ray procedure for five-year period.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you for that and thank you for your time and assistance. I wish you a great day.
[AGENT][NEUTRAL] Yes, sir, and if you, yes sir, and if you need a copy of that explanation of benefits now, then you can print it now that you have the claim number by going to our portal at [PII].
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome. And is there anything else I can help you with today?
[CUSTOMER][NEUTRAL] No, thank you. Bye.
[AGENT][POSITIVE] OK, well thank you for calling APO have a great day.