AccountId: 011433970860
ContactId: 78ed92a1-0433-43c7-aba6-41d98d3c2f29
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 583820 ms
Total Talk Time (AGENT): 140794 ms
Total Talk Time (CUSTOMER): 124601 ms
Interruptions: 0
Overall Sentiment: AGENT=1.2, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/10/78ed92a1-0433-43c7-aba6-41d98d3c2f29_20250110T21:14_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. Uh, good afternoon. This is [PII] calling from provider office. How are you doing today?
[AGENT][POSITIVE] I'm doing good, [PII]. How are you doing?
[CUSTOMER][NEUTRAL] Uh, I'm well. Uh, actually, I need the claim status.
[AGENT][NEUTRAL] You need client status, is that correct?
[CUSTOMER][NEUTRAL] Yes, yes, yeah.
[AGENT][NEUTRAL] OK, I, I can help you with claims status, [PII]. What is your callback number just in case our call is disconnected?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm. Yes. Uh, the callback number is [PII].
[AGENT][NEUTRAL] OK, thank you. And then what is um the patient's name?
[CUSTOMER][NEUTRAL] Mhm. The patient, ma'am.
[CUSTOMER][NEUTRAL] The value
[CUSTOMER][POSITIVE] Great, yeah.
[AGENT][NEUTRAL] OK. And what's [PII]'s date of birth, please?
[CUSTOMER][NEUTRAL] Date of birth, [PII].
[AGENT][NEUTRAL] Thank you and then what is the patient's policy number?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, it's 02443441.
[AGENT][NEUTRAL] OK, that's 0244341.
[CUSTOMER][NEUTRAL] No. 02443441.
[AGENT][NEUTRAL] 344-1. OK, let me pull in that policy real quick.
[CUSTOMER][POSITIVE] Mhm, no problem.
[CUSTOMER][POSITIVE] All up easily.
[AGENT][NEUTRAL] OK, and what is the data service for [PII]?
[CUSTOMER][NEUTRAL] Mhm date of service.
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] And the charge amount?
[CUSTOMER][NEUTRAL] Uh, $236.
[AGENT][NEUTRAL] $236?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yes, yes.
[AGENT][NEUTRAL] OK, and then what is the charge amount after the primary insurance paid their part?
[CUSTOMER][NEUTRAL] Mm, uh, uh, $25.
[AGENT][NEUTRAL] OK. And then can you please give me the name of the facility you're calling for?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] It's for family medicine.
[AGENT][NEUTRAL] OK, I'm gonna put you on a brief hold, [PII]. I'm gonna look up that claim for you and I'll be right back.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK, OK.
[AGENT][POSITIVE] Thank you, sir.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] OK [PII], I've got the claim pulled up. Thank you so much for holding for me.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I do see the claim number is.
[CUSTOMER][NEUTRAL] Yes, OK.
[AGENT][NEUTRAL] 348-7986.
[CUSTOMER][NEUTRAL] 348-7986.
[AGENT][NEUTRAL] The claim
[AGENT][NEUTRAL] Yes, that's the claim number. The claim was received on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The claim was processed on [PII].
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] And the claim was denied because office visits are not covered under the patient's policy.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Because what reason office visits are not covered?
[AGENT][NEUTRAL] Oh.
[AGENT][POSITIVE] Yes, that's, that's correct. It's a non-covered service.
[CUSTOMER][NEUTRAL] Just wait a moment.
[AGENT][POSITIVE] Yes, please take your time.
[CUSTOMER][NEUTRAL] OK. Uh, give me a call reference number for this patient.
[AGENT][NEUTRAL] Yes, you can use my name. It's [PII]
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] And today's date.
[CUSTOMER][NEUTRAL] Uh, this is car reference number?
[AGENT][NEUTRAL] Yes, my name is [PII] and today's date.
[CUSTOMER][NEUTRAL] OK. Uh just wait a moment.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEGATIVE] I just not gonna work I can know.
[AGENT][NEUTRAL] Sorry, what did you just ask me?
[CUSTOMER][NEUTRAL] Just, just it a moment, that's it.
[AGENT][POSITIVE] OK, OK, well you have a good weekend and thank you for calling APL.
[CUSTOMER][NEUTRAL] Mhm. Uh, just wait a moment. Hello?
[AGENT][NEUTRAL] Hi I'm here.
[CUSTOMER][NEUTRAL] Uh-huh. Uh, can you pull up another one, data service for the same patient?
[AGENT][NEUTRAL] Uh, yes, um, what is the date of service?
[CUSTOMER][NEUTRAL] Uh, it's [PII].
[AGENT][NEUTRAL] OK, so [PII] you have to allow 7 to 10 business days for the claim to be processed.
[CUSTOMER][NEUTRAL] OK. Uh.
[CUSTOMER][POSITIVE] OK. Uh, [PII], have a great day. Take care. Bye-bye.
[AGENT][POSITIVE] You too. Thank you, [PII]. You have a good weekend. Bye bye.
[CUSTOMER][NEUTRAL] OK, but we can.