AccountId: 011433970860
ContactId: 80ae48a8-41f4-4769-b836-c8206ed2b936
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 333579 ms
Total Talk Time (AGENT): 98603 ms
Total Talk Time (CUSTOMER): 118300 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/23/80ae48a8-41f4-4769-b836-c8206ed2b936_20250123T21:21_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm calling from provider's office and looking for claim status.
[AGENT][POSITIVE] [PII], it would be my pleasure to assist you with claim status today. What is the callback number?
[CUSTOMER][NEUTRAL] Yes, callback number is [PII].
[AGENT][NEUTRAL] Thank you, [PII]. And what is the policy number for the patient, please?
[CUSTOMER][NEUTRAL] Yes, uh, policy number is
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] 02514350.
[AGENT][NEUTRAL] Thank you, [PII]. And what is the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] Patient name is [PII]. Date of birth is [PII].
[AGENT][POSITIVE] All right, thank you, and it would be my pleasure to assist you with that claim status for the patient. Do you have a claim number or date of service?
[CUSTOMER][NEUTRAL] So I have a date of service and the amount which is July 23, [PII].
[AGENT][NEUTRAL] Alright, what's that?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] The bill amount is $216 even.
[AGENT][NEUTRAL] All right, thank you and [PII], what is the facility name?
[CUSTOMER][NEGATIVE] Uh, I'm calling from just from [PII].
[AGENT][POSITIVE] All right, thank you.
[AGENT][POSITIVE] [PII], it would be my pleasure to help you with that claim information. We received that claim on [PII].
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] I
[AGENT][NEGATIVE] It was processed and denied on.
[AGENT][NEUTRAL] [PII]?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEGATIVE] And it was denied because office visits are not covered under the patient's plan.
[CUSTOMER][NEUTRAL] No
[AGENT][NEUTRAL] Would you like that claim number?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] The claim number is 350.
[AGENT][NEUTRAL] 8942.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I believe.
[CUSTOMER][NEUTRAL] Alright.
[AGENT][NEUTRAL] Anything else I can help you with today?
[CUSTOMER][NEUTRAL] Uh, just a minute.
[AGENT][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] If I know
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Can you hold for just one minute?
[AGENT][NEUTRAL] I can.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] What
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] OK. Thank you so much for patiently waiting. May I know your patient's plan name?
[AGENT][NEUTRAL] It is a Medlink gap policy.
[CUSTOMER][NEUTRAL] Is it uh like uh HMO or PPO EPO plan?
[AGENT][NEUTRAL] It is a supplemental policy to their major medical coverage.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] The chocolate
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] We got you.
[CUSTOMER][NEUTRAL] Do.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, uh, and, uh, is the provider in network or out of network?
[AGENT][NEUTRAL] With the secondary policy, there is no network. We follow the guidelines of the major medical.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] She's like you.
[CUSTOMER][NEUTRAL] OK. May I know your car reference number?
[AGENT][NEUTRAL] The reference number would be my name and today's date, and I spell my name [PII]
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] First initial of my last name is [PII].
[AGENT][POSITIVE] And it was a pleasure to assist you with that claim status. Is there anything else I can help you with today?
[CUSTOMER][POSITIVE] No, thank you. Thank you so much. Thank you so much for the information. Have a great day. Bye-bye.
[AGENT][POSITIVE] It was my pleasure to assist you. Thank you for calling APL and have a wonderful day as well. Take care.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Bye bye.