AccountId: 011433970860
ContactId: 6e9477dd-1842-414f-b613-afac6a32f71a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 202710 ms
Total Talk Time (AGENT): 45380 ms
Total Talk Time (CUSTOMER): 80779 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/20/6e9477dd-1842-414f-b613-afac6a32f71a_20250620T13:51_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII]. I'm calling from the provider's offices regarding the claim.
[AGENT][NEUTRAL] OK, [PII], I can help you with claim status. Do you have a good callback number?
[CUSTOMER][NEUTRAL] The callback number is [PII].
[AGENT][NEUTRAL] OK, thank you. And the policy number for the patient?
[CUSTOMER][NEUTRAL] Yes, it's going to be um 02552103.
[AGENT][NEUTRAL] And patient name and date of birth?
[CUSTOMER][NEUTRAL] The patient's name is uh [PII], and date of birth is the [PII].
[AGENT][NEUTRAL] And date of service and bill charges?
[CUSTOMER][NEUTRAL] Yes, of course. The data is going to be [PII]. The total charge amount is, I'm sorry, $290 even. And in the claim, the claim was denied as a non-covered charges. Could you please confirm why?
[AGENT][NEUTRAL] Um, office visits are not covered under this policy.
[CUSTOMER][NEUTRAL] Oh, OK. The offer does not cover under the policy, is that right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK. Is the patients responsibility or providers responsibility?
[AGENT][NEUTRAL] Um, we can't determine patient responsibility as a secondary policy.
[CUSTOMER][NEUTRAL] I'm sorry?
[AGENT][NEUTRAL] We can't determine or instruct on patient responsibility because this is a secondary policy.
[CUSTOMER][NEUTRAL] OK. And this was the secondary. Which insurance is the primary?
[AGENT][NEUTRAL] Um, it is.
[AGENT][NEUTRAL] Oh, I'm sorry, I clicked out of the wrong thing. Can you give me that policy number one more time? Sorry about that.
[CUSTOMER][NEUTRAL] Yes, of course, the policy number is going to be 02552103.
[AGENT][NEUTRAL] Uh, the primary insurance is America's Choice.
[CUSTOMER][NEUTRAL] Medicare?
[AGENT][NEUTRAL] America's Choice.
[CUSTOMER][NEUTRAL] American Choice. Do you have uh that uh ID member ID number?
[AGENT][NEUTRAL] No, I don't.
[CUSTOMER][NEUTRAL] OK. The American Cho listed as a primary in your system, right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, that's no problem, ma'am. And uh do you have any call reference number, [PII], and uh what's the time limit, uh, what's the, I mean, a time limit for it?
[AGENT][NEUTRAL] Uh, there's no timely filing limit and call reference number is my name, [PII], and today's date.
[CUSTOMER][POSITIVE] OK, [PII], that is, that's all. Thank you so much for your assistance. Have a wonderful day. Bye for now.
[AGENT][POSITIVE] Thanks for calling APL. You too. Bye-bye.
[CUSTOMER][NEUTRAL] Mhm.