AccountId: 011433970860
ContactId: 6a8da445-dfc5-43c7-87f6-4d59ab50a79d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 843520 ms
Total Talk Time (AGENT): 155988 ms
Total Talk Time (CUSTOMER): 209153 ms
Interruptions: 1
Overall Sentiment: AGENT=-0.1, CUSTOMER=-0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/06/6a8da445-dfc5-43c7-87f6-4d59ab50a79d_20250506T19:39_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII] and I'm calling from provider office. I want to know the claim status.
[AGENT][NEUTRAL] OK, I'm sorry. What was your name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And can you spell that for me?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, I'm sorry, I did not get that. Can you spell it one more time?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Do you have a callback number I can get in case we get disconnected I can call you back.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And do you have the policy number?
[CUSTOMER][NEUTRAL] 02566508
[AGENT][NEUTRAL] OK, I'm sorry, can you repeat that one more time? 02.
[CUSTOMER][NEUTRAL] 566508
[AGENT][NEUTRAL] Thank you, [PII]. Hold on one moment.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Can you please repeat?
[AGENT][NEUTRAL] Yeah, I said, thank you, [PII]. Hold on one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And what's the patient's name?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] What's the patient's name?
[CUSTOMER][NEUTRAL] It's [PII]
[CUSTOMER][NEUTRAL] The last name is [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] Thank you, [PII], and you were needing claim status?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, I can help you with that. What data service is it for?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the total bill amount?
[CUSTOMER][NEUTRAL] The total bill amount was
[CUSTOMER][NEUTRAL] $448.39.
[AGENT][POSITIVE] Thank you, hold on one moment please. I can look that up for you.
[AGENT][NEUTRAL] And what was one of the procedure codes on that bill?
[CUSTOMER][NEUTRAL] The procedure code we are built.
[CUSTOMER][NEGATIVE] All of the paid, but the one line item is 7038 was not paid.
[AGENT][NEUTRAL] A 7038.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Hold on one moment.
[AGENT][NEUTRAL] Anything that is disposable is not covered.
[CUSTOMER][NEUTRAL] Mm, and the patient policy?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Your insurance guideline.
[AGENT][NEGATIVE] What did you say? I didn't understand you.
[CUSTOMER][NEUTRAL] It is not covered under the patient plan or the insurance?
[CUSTOMER][NEGATIVE] Not covered it.
[AGENT][NEGATIVE] It's not covered at all.
[CUSTOMER][NEUTRAL] By the AARP.
[AGENT][NEUTRAL] Anything disposable is not covered.
[AGENT][NEUTRAL] Right
[CUSTOMER][NEUTRAL] Anything is disposable, is not covered under the insurance guideline.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK. So.
[AGENT][NEUTRAL] Under the patient's policy is not covered.
[CUSTOMER][NEUTRAL] OK, uh not covered under the patient policy.
[CUSTOMER][NEUTRAL] Allow me a minute.
[CUSTOMER][NEUTRAL] But primary
[CUSTOMER][POSITIVE] It's paid for the right line item.
[AGENT][NEGATIVE] But it's not covered by our policy no matter what the uh primary paid. His policy with us, it is not covered.
[CUSTOMER][NEUTRAL] Let me check previously I think.
[AGENT][NEUTRAL] Right
[AGENT][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] So it is a patient responsibility?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Allow me a minute.
[CUSTOMER][NEUTRAL] When the claim was received?
[AGENT][NEUTRAL] Hold on just a moment.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] It was received 4 725?
[CUSTOMER][NEUTRAL] 472025 and process it?
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] 4 11:25.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK, the claim number, sorry, I have.
[CUSTOMER][NEUTRAL] Can you please provide the claim number?
[AGENT][NEUTRAL] 358-728-9.
[CUSTOMER][NEUTRAL] OK. Can you please spell your name?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] OK. Call reference number for this patient?
[AGENT][NEUTRAL] We do not have call reference numbers you can use my name and today's date.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Thank you, [PII], for calling AP.
[CUSTOMER][NEUTRAL] The next patient I have.
[CUSTOMER][NEUTRAL] Hello. I have one more patient.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] One more, OK.
[AGENT][NEUTRAL] Hold on one moment.
[CUSTOMER][NEUTRAL] OK. Uh, total only one more patient.
[AGENT][NEUTRAL] Hold on.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Can you please provide the patient plan first for the last patient?
[CUSTOMER][NEUTRAL] Plant name
[AGENT][NEUTRAL] Midlink
[CUSTOMER][NEUTRAL] Medley. Can you please it is [PII]
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Ma
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Hold on one moment.
[CUSTOMER][NEUTRAL] It is not
[AGENT][NEUTRAL] OK, and the next policy number?
[CUSTOMER][NEUTRAL] Yeah, it's 01457153.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And the patient's name.
[CUSTOMER][NEUTRAL] The patient name is [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] Data service.
[CUSTOMER][NEUTRAL] Date of service is [PII].
[CUSTOMER][NEUTRAL] [PII]. And the bill amount was
[CUSTOMER][NEUTRAL] The amount is $68.42.
[AGENT][NEUTRAL] 6842.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And what's the procedure code?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] What's the procedure code?
[CUSTOMER][NEUTRAL] The procedure code is L3908.
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEUTRAL] L as in Lima 3908.
[AGENT][NEUTRAL] I heard you. Hold on one moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It is
[CUSTOMER][NEUTRAL] L as in Lima 3908.
[AGENT][NEGATIVE] OK, we did get that claim in, it was denied.
[AGENT][NEGATIVE] DME is not covered under this policy.
[CUSTOMER][NEGATIVE] The DM is not covered.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] We
[CUSTOMER][NEUTRAL] Patient plan name?
[AGENT][NEUTRAL] Medlink.
[CUSTOMER][NEUTRAL] Meddling
[CUSTOMER][NEUTRAL] OK, which is not covered, uh.
[CUSTOMER][NEUTRAL] But previously the meddling cover DM.
[CUSTOMER][NEUTRAL] And allow a minute, there is any more information for the.
[CUSTOMER][NEGATIVE] So [PII]
[CUSTOMER][NEUTRAL] No cover the, the plan of to me. Can you please provide the claim number and this?
[AGENT][NEUTRAL] Claim number is 3582712.
[CUSTOMER][NEUTRAL] Can you please slow it?
[CUSTOMER][NEUTRAL] 358
[AGENT][NEUTRAL] 27
[AGENT][NEUTRAL] 12.
[CUSTOMER][NEUTRAL] And received it?
[AGENT][NEUTRAL] 327, 25.
[AGENT][NEUTRAL] The 9 331.
[AGENT][NEUTRAL] 25.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes, can you please repeat?
[AGENT][NEUTRAL] It was received on 327-25.
[AGENT][NEUTRAL] Denied
[CUSTOMER][NEUTRAL] And plus
[AGENT][NEUTRAL] 33125.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Yes, thank you.
[AGENT][POSITIVE] Thank you for calling APL James. You have a good day.
[CUSTOMER][NEUTRAL] Like