AccountId: 011433970860
ContactId: 6e968220-21c9-4c6c-9519-8916014931d0
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 206970 ms
Total Talk Time (AGENT): 68989 ms
Total Talk Time (CUSTOMER): 87571 ms
Interruptions: 1
Overall Sentiment: AGENT=1.2, CUSTOMER=1.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/18/6e968220-21c9-4c6c-9519-8916014931d0_20250618T13:08_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Uh yes. Hi, good morning, [PII]. I am calling for a claim status.
[AGENT][NEUTRAL] OK. May I ask who's calling?
[CUSTOMER][NEUTRAL] Yes, my name is [PII] and I am calling from uh Coral Gables Dermatology and Aesthetics.
[AGENT][NEUTRAL] OK. And do you have a phone number I can get in case we get disconnected, I can call you back?
[CUSTOMER][NEUTRAL] Yes, that's [PII].
[AGENT][NEUTRAL] And do you have their policy number?
[CUSTOMER][NEUTRAL] Yes, policy is 02611391.
[AGENT][NEUTRAL] Thank you, [PII]. Hold on one moment, please.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] And what's the patient's name?
[CUSTOMER][NEUTRAL] Alright, this patient's name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Thank you, [PII]. And you were just needing benefits?
[CUSTOMER][NEUTRAL] Uh, claims. I have data service for [PII].
[AGENT][NEUTRAL] Claim status. I'm sorry, I apologize.
[CUSTOMER][NEUTRAL] That's OK, that's OK, dear. It's for [PII].
[AGENT][NEUTRAL] OK, I can look that up for you, just a moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] And what was the total charge for that?
[CUSTOMER][NEUTRAL] That was $234.55.
[AGENT][NEUTRAL] OK, we do have the claim in. It was denied. Office visits are not covered under this policy.
[CUSTOMER][NEUTRAL] Mm, office visits.
[CUSTOMER][NEGATIVE] Are not covered. And when did you receive them?
[CUSTOMER][NEUTRAL] This claim?
[AGENT][NEUTRAL] Hold on just a moment. I can look that up for you.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] 6425.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And it was denied 6925.
[CUSTOMER][POSITIVE] Perfect. And is there a claim number?
[AGENT][NEUTRAL] 361-094-1
[CUSTOMER][POSITIVE] Thank you so much.
[CUSTOMER][NEUTRAL] Now, um, I guess the patient is responsible for the $70 that the primary didn't cover. OK. Um, did you guys send us a denial for this, um, uh, like an EOB uh statement for this?
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Yes, ma'am. It went, it went out on the, uh, [PII], so you may not have gotten it yet.
[CUSTOMER][POSITIVE] Exactly. OK. That's all righty. Thank you very much, [PII]. I just need a reference number for the call.
[AGENT][NEUTRAL] We do not have reference numbers. You can use my name in today's date. Is there anything else I can help you with?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, perfect. Alrighty, well thank you very much. Have a wonderful day.
[AGENT][POSITIVE] Thank you, [PII], for calling APLU as well.
[CUSTOMER][POSITIVE] Take care. Bye-bye.
[AGENT][POSITIVE] Thank you. Bye-bye.
[CUSTOMER][NEUTRAL] Bye bye.