AccountId: 011433970860
ContactId: 6cfead24-85c3-4d19-8964-63c54f61cf74
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 406640 ms
Total Talk Time (AGENT): 94768 ms
Total Talk Time (CUSTOMER): 80924 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=-0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/12/6cfead24-85c3-4d19-8964-63c54f61cf74_20250312T15:06_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. This is [PII] calling from provider's office. I'm checking for the claim status. Can you please spell out your name for my documentation purpose? And this call is getting recorded for the quality training purpose.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, my name is [PII] And can you please spell your name?
[CUSTOMER][NEUTRAL] Yeah, it is [PII]
[CUSTOMER][NEUTRAL] And sorry, your name spells like [PII], that's it?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, yes, ma'am.
[CUSTOMER][NEUTRAL] 98015.
[AGENT][NEUTRAL] OK, Ms. [PII], can you please give me your callback number?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Um
[AGENT][NEUTRAL] Thank you, ma'am. And then what is the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] [PII], date of birth [PII], uh sorry, [PII] and the member ID it is 01988939.
[AGENT][NEUTRAL] OK, and you're looking for claim status, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, let me look real quick.
[AGENT][NEUTRAL] OK and what is the date of service please?
[CUSTOMER][NEUTRAL] The date of service, it is [PII] for the bill amount of $397 even.
[AGENT][NEUTRAL] OK, and what is the charge amount after the primary insurance paid their part?
[CUSTOMER][NEUTRAL] $50.
[AGENT][NEUTRAL] Thank you and then can you please give me the name of the facility you're calling for?
[CUSTOMER][NEUTRAL] Vital MD Group Holding LLC.
[AGENT][NEUTRAL] OK, I'm gonna put you on a quick hold, Ms. [PII], while I pull up this claim, and then I'll be right back.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] It's one more quick um.
[AGENT][NEUTRAL] Review, you said the date of service was [PII]?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]. OK, alright, let me look real quick.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Thank you for holding for me. I did find the claim. The claim number is 356.
[AGENT][NEUTRAL] 0993.
[AGENT][NEUTRAL] And the claim was denied because it's non-covered service in the doctor's office or clinic.
[CUSTOMER][NEUTRAL] OK. uh, which plan does patient have?
[AGENT][NEUTRAL] Medlink
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] Medlink M E D L I N K.
[CUSTOMER][NEUTRAL] Can you please
[CUSTOMER][NEUTRAL] Can you please spell it?
[AGENT][NEUTRAL] M E D L I N K.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] So, uh, according to patient plan, it does not cover, right?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Right, office visits are non-covered on the patient's plan.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So uh.
[CUSTOMER][NEUTRAL] Can I have the call reference number?
[AGENT][NEUTRAL] Yes ma'am, you can use my name [PII] and today's date.
[CUSTOMER][POSITIVE] Thank you so much. Bye for now. Bye-bye.
[AGENT][POSITIVE] Bye bye. Have a good day, [PII]. Thanks for calling APL.