AccountId: 011433970860
ContactId: 7a2e72c5-4d47-4b68-a9f8-126158adcd86
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 518150 ms
Total Talk Time (AGENT): 114106 ms
Total Talk Time (CUSTOMER): 83529 ms
Interruptions: 0
Overall Sentiment: AGENT=1.2, CUSTOMER=-0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/02/7a2e72c5-4d47-4b68-a9f8-126158adcd86_20250602T14:16_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, good morning, my name is [PII]. I was calling to get information regarding claim status.
[AGENT][NEUTRAL] OK, I can help you with the claim, Ms. [PII]. May I please get your callback number, ma'am, just in case our call is disconnected.
[CUSTOMER][NEUTRAL] [PII] and it's the direct line.
[AGENT][NEUTRAL] Thank you. And then what is the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] First name is [PII], last name is [PII].
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[CUSTOMER][NEUTRAL] Um, policy number that I have is 02041973ML8.
[AGENT][NEUTRAL] OK, let me pull up his policy.
[AGENT][POSITIVE] Real quick.
[AGENT][NEUTRAL] Alright and then what is the date of service and the charge amount?
[CUSTOMER][NEUTRAL] [PII] total charge amount is $507.
[AGENT][NEUTRAL] And then what are the charges after the primary insurance paid their part?
[CUSTOMER][NEUTRAL] Yes, one moment.
[CUSTOMER][NEUTRAL] Um, it looks like it left the patient with a co-payment of $80.
[AGENT][NEUTRAL] Thank you, and then may I please have the name of the facility you're calling for?
[CUSTOMER][NEUTRAL] University Medical Service Associations Inc.
[AGENT][NEUTRAL] OK, I'm gonna put you on a quick hold, [PII], while I look up this claim for us, and I'll be right back.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] You're welcome
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Come on.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK, what is the amount $80.
[AGENT][NEUTRAL] 507.
[AGENT][NEUTRAL] That's duplicate.
[AGENT][NEUTRAL] 343-853-1.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you so much for holding for me, Miss [PII]. I have the claim information for you.
[AGENT][NEUTRAL] The claim number is 343.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 853 1.
[AGENT][NEUTRAL] And the claim has been denied. Uh, let me let you know the reason. Well, two reasons. One, office visits are not covered under the patient's plan.
[AGENT][NEUTRAL] And then also on the other ones uh this policy does not provide a benefit for service in which no charges were incurred.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Can you email or fax over the EOB?
[AGENT][NEUTRAL] Yes ma'am, what is your fax number?
[CUSTOMER][NEUTRAL] Yes, fax number is [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][POSITIVE] And if you could put attention my name [PII] last initial [PII], that would be great.
[AGENT][NEUTRAL] OK, Ms. [PII], I'm gonna put you on a hold again while I get that fax ready for you and I will be right back.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Come on.
[AGENT][POSITIVE] Thank you for holding for me, Ms. [PII].
[AGENT][NEUTRAL] I have that fax on its way to you now, ma'am.
[CUSTOMER][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] OK, thank you for your time. You said your name is [PII]. If there's a, is is there a reference number for today's call?
[AGENT][NEUTRAL] Yes, you can use my name and today's date.
[CUSTOMER][NEUTRAL] OK. Is that spelled [PII]?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Right, OK, and what's the initial to your last name?
[AGENT][NEUTRAL] It's [PII]
[CUSTOMER][POSITIVE] OK, thank you. You have a great rest of the day.
[AGENT][POSITIVE] You too, Ms. [PII]. Thank you for calling APL.
[AGENT][POSITIVE] You take care.
[CUSTOMER][NEUTRAL] You as well bye.
[AGENT][NEUTRAL] Bye bye.