AccountId: 011433970860
ContactId: 838b306b-6a69-468c-986d-97157e6de6e6
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 459160 ms
Total Talk Time (AGENT): 158438 ms
Total Talk Time (CUSTOMER): 140026 ms
Interruptions: 1
Overall Sentiment: AGENT=1.4, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/27/838b306b-6a69-468c-986d-97157e6de6e6_20250127T16:45_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] Yeah. Hi, [PII]. This is [PII]. I'm calling from Epiphany Dermatology of PA to check on the claim information.
[AGENT][NEUTRAL] Mhm
[AGENT][POSITIVE] Well, it would be my pleasure to assist you. And [PII], what is a good callback number?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It's [PII] [PII].
[AGENT][NEUTRAL] Thank you, [PII], and what is the policy number?
[CUSTOMER][NEUTRAL] It's 02341573.
[AGENT][NEUTRAL] Thank you, [PII]. And the patient's name and date of birth?
[CUSTOMER][NEUTRAL] It's [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] All right, thank you. And you are needing eligibility?
[CUSTOMER][NEUTRAL] Uh, no, I'm looking for claim status.
[AGENT][NEUTRAL] All right, and I can help you with that claim status for [PII] and [PII], what is the data service?
[CUSTOMER][NEUTRAL] Uh, the date of service is [PII]. Bill amount $319.44.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And you said you're with Epiphany dermatology?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] All right, thank you. And it would be my pleasure to assist you with that claim status. I am showing that we received that claim on [PII].
[AGENT][NEUTRAL] The claim was processed on to [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And the claim was denied as a non-covered service, this policy does not provide benefits for the office visit.
[CUSTOMER][NEUTRAL] Uh, sorry, this service was
[AGENT][NEUTRAL] This policy does not provide policy does not provide benefits for the office visit. So any services in the doctor's office is not covered.
[CUSTOMER][NEUTRAL] Could you repeat that one more
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, got it. And uh yeah, could you please provide me the claim number?
[AGENT][NEUTRAL] Claim number is 342.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 0773.
[CUSTOMER][NEUTRAL] 0773, right?
[AGENT][POSITIVE] Yes, ma'am. That is correct.
[CUSTOMER][NEUTRAL] Uh yeah, and could you please provide us the UOB?
[AGENT][NEUTRAL] EOBs are obtainable on our portal at secured.
[CUSTOMER][NEUTRAL] Because we didn't
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] M
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]. Secured.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII], right?
[AGENT][NEUTRAL] That is correct, and it's a self registration using.
[CUSTOMER][NEUTRAL] Is it need to be, uh, need to be, I mean, uh, logged in. Do we need any permission or can we log out? So, can we log in directly?
[AGENT][NEUTRAL] You can log in directly.
[AGENT][NEUTRAL] Yeah, we need to create a, a login and password, but it's so it's um, self registration using your tax ID number and the patient's account number listed in box 26 on the HIPAA.
[CUSTOMER][NEUTRAL] OK, so you don't uh
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, just, uh, give me one moment.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, here, uh, it's showing as if I'm trying to open it's showing as I'm an individual with APL insurance policy. There are so many on the media and I'm writing agent broker. I'm an employee or group who offers AL products to my employees with many.
[AGENT][NEUTRAL] You're gonna choose the last one.
[AGENT][NEUTRAL] Your medical or dental provider. Yeah.
[CUSTOMER][NEUTRAL] I'm in uh medical name.
[CUSTOMER][POSITIVE] Oh, thank you so much. Actually, I don't know, so I'm just uh
[AGENT][POSITIVE] It's my pleasure.
[AGENT][NEUTRAL] Take your time if you want to go ahead and I can give you the patient account number when you're at that point.
[CUSTOMER][NEUTRAL] Oh yeah, sure. Just a moment, um.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, could you please provide me the patient account number?
[AGENT][NEUTRAL] Yes, ma'am. It is C as in Charlie, B as in Bravo, 01.
[AGENT][NEUTRAL] G as in Golf, 7, K as [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 024.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 024 OK.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] So every time we, uh, I mean, uh, once we, it's asking username, so we can keep random username, right?
[AGENT][NEUTRAL] Right, you would just create a username and password.
[CUSTOMER][NEUTRAL] Oh, just a moment, please.
[AGENT][POSITIVE] OK, take your time.
[CUSTOMER][NEUTRAL] So for another members also, we can check in this uh portal, right?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] So, just so we can just
[AGENT][NEUTRAL] You can also sub make claims.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Uh, just a moment. I'm so sorry. It's taking a little bit of time.
[AGENT][POSITIVE] You're fine. You take your time.
[CUSTOMER][NEUTRAL] Yeah. And uh could you please provide us the
[CUSTOMER][NEUTRAL] Call reference number?
[AGENT][NEUTRAL] Call reference number is my name and today's date. And I spell my name, [PII]
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK. [PII], OK.
[AGENT][NEUTRAL] First initial, last name, [PII].
[CUSTOMER][POSITIVE] OK. Uh thank you so much, [PII]. It's really a pleasure to talk with you. And thank you so much for the help.
[AGENT][POSITIVE] Well, it's been my pleasure and thank you for calling APL. You have a wonderful day, [PII].
[CUSTOMER][POSITIVE] Thank you. Bye-bye. Take care.
[AGENT][POSITIVE] Bye-bye. Mhm. You too.