AccountId: 011433970860
ContactId: 74602a3a-2fff-4b6d-a67c-07b36bf1285b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 228589 ms
Total Talk Time (AGENT): 52921 ms
Total Talk Time (CUSTOMER): 88480 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/28/74602a3a-2fff-4b6d-a67c-07b36bf1285b_20250528T21:21_UTC.wav
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[AGENT][NEUTRAL] Calling APL, my name is [PII]. How can I assist you today?
[CUSTOMER][NEUTRAL] Yeah, hi, [PII]. I'm [PII]. I'm calling from provider's office regarding our claims.
[AGENT][POSITIVE] I'd be happy to assist with claims today [PII] if I can get a good call back number for you.
[CUSTOMER][NEUTRAL] The callback number is [PII] of [PII].
[AGENT][NEUTRAL] And what is the policy number?
[CUSTOMER][NEUTRAL] The policy number is going to be uh.
[CUSTOMER][NEUTRAL] 02263078 M as in Mike L as in Lima 8.
[AGENT][NEUTRAL] Patient's name and date of birth.
[CUSTOMER][NEUTRAL] Uh, patient's first name is going to be, it's uh
[CUSTOMER][NEUTRAL] [PII] and the last name is [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] Data service for the claim?
[CUSTOMER][NEUTRAL] The rate of service is [PII]. [PII] with the amount of $410 even.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] You said [PII]?
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[AGENT][NEUTRAL] April
[AGENT][NEUTRAL] And the tax ID?
[CUSTOMER][NEUTRAL] The tax ID is uh
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you for that information. I'm showing the claim denied because office office visits are not covered under the policy.
[CUSTOMER][NEUTRAL] Mhm. May I know when the claim has been issued?
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] Claim was received on [PII], claim denied on [PII].
[CUSTOMER][NEUTRAL] [PII]. Got it. Mhm.
[CUSTOMER][NEUTRAL] Uh, I, I stating that office visits 99 CPT 99244 is not covered on this members plan, right? Mhm.
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] Got it. May I know, could you please help me in the member's plan name?
[AGENT][NEUTRAL] Midli gap.
[CUSTOMER][NEUTRAL] Midli
[CUSTOMER][NEUTRAL] Gap insurance, right?
[AGENT][NEUTRAL] Medin gap, yes.
[CUSTOMER][NEUTRAL] I like jam. Got it. Could you please help me with the claim number?
[AGENT][NEUTRAL] Claim number is 359-530-7.
[CUSTOMER][NEUTRAL] 3595307. OK. In this case, can you send me the copy of your ID through fax.
[AGENT][NEUTRAL] OK. What's that, um, fax number?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And to whose attention?
[CUSTOMER][NEUTRAL] You're gonna mention my name [PII]
[AGENT][POSITIVE] Alright, you should receive that within the next 15 minutes. Was there anything else I can assist with today?
[CUSTOMER][NEUTRAL] Uh, nothing else, [PII]. Uh may I know the call reference, please, that's it all the information I need.
[AGENT][NEUTRAL] Reference is just my name [PII] last initial [PII], and the date and time of the call.
[CUSTOMER][POSITIVE] Thank you, [PII]. That's it all the information I need. Thank you for assistance, ma'am. Bye for now.
[AGENT][POSITIVE] Thank you for calling APL have a good day.