AccountId: 011433970860
ContactId: 78c0ba8d-a934-4943-a501-b49b870c1033
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 158539 ms
Total Talk Time (AGENT): 58848 ms
Total Talk Time (CUSTOMER): 55087 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/24/78c0ba8d-a934-4943-a501-b49b870c1033_20250124T19:06_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yes, I need to um check status on a claim.
[AGENT][NEUTRAL] Can help you. What is your name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And are you calling on behalf of a provider's office?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, I'll need the policy number and a good phone number in case we're disconnected.
[CUSTOMER][NEUTRAL] Sure, I have 01988261 and the phone number is [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] Thank you for that information and you said you're checking claim status?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] All right, we can assist with the information. um, what's the date of service and the total charge?
[CUSTOMER][NEUTRAL] Sure, that is 816 24 and the bill amount was $240.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] Alright, so I showed the claim was received [PII], processed [PII]. Uh, no payment was made, uh, office visits are not covered by the patient's policy.
[CUSTOMER][NEUTRAL] 5
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEGATIVE] Not covered
[CUSTOMER][NEUTRAL] Policy perfect alright and do you show that you're secondary or primary?
[CUSTOMER][NEUTRAL] Uh, um, for this insured.
[AGENT][NEUTRAL] Now this policy is secondary to the major medical plan.
[CUSTOMER][POSITIVE] OK, perfect.
[AGENT][NEUTRAL] Any other questions? Mhm.
[CUSTOMER][NEUTRAL] And the patient, um, yeah, is the patient responsible?
[AGENT][NEUTRAL] We do not determine patients responsibility, and you can also, you can also check your status online at [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK perfect all right and do you have a reference number?
[AGENT][NEUTRAL] My name and today's date, [PII] First initial and last name is [PII], and anything else.
[CUSTOMER][NEUTRAL] Nope, that'll be it.
[AGENT][POSITIVE] Alrighty, thank you for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] You too bye.
[AGENT][NEUTRAL] Bye bye.