AccountId: 011433970860
ContactId: 83c9ba80-f6e9-4a42-87e1-ea5cb08e9a11
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 172119 ms
Total Talk Time (AGENT): 67048 ms
Total Talk Time (CUSTOMER): 94830 ms
Interruptions: 4
Overall Sentiment: AGENT=0, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/06/83c9ba80-f6e9-4a42-87e1-ea5cb08e9a11_20250206T14:17_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling American Public Life. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, good morning. My name is [PII] calling from the provider office, Neurospine Institute, and I'm checking for a claim status.
[AGENT][NEUTRAL] I can verify claim status. May I have a policy number?
[CUSTOMER][NEUTRAL] Yes, the policy number for the patient is 60801.
[AGENT][NEUTRAL] That is our payer ID.
[CUSTOMER][NEUTRAL] Her ID
[CUSTOMER][NEUTRAL] I'm sorry?
[AGENT][NEUTRAL] That is not a policy number.
[CUSTOMER][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] OK, one moment. Let me verify from the documents.
[CUSTOMER][NEUTRAL] Yes, the policy number is 02487974.
[AGENT][NEUTRAL] May I have a good callback number for you?
[CUSTOMER][NEUTRAL] Yes, the callback number is [PII] with an extension number [PII].
[AGENT][NEUTRAL] May I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Patient name is [PII]. Date of birth of [PII].
[AGENT][NEUTRAL] Thank you for verifying that information. May I have the date of service?
[CUSTOMER][NEUTRAL] Yes, the date of service for the claim is [PII].
[CUSTOMER][NEUTRAL] Total charge amount billed is $1,731 even.
[AGENT][NEUTRAL] Thank you for future reference, you may visit our website at [PII] to check claim status as well.
[CUSTOMER][NEUTRAL] Well
[AGENT][NEUTRAL] This processed under claim number 3551056.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] That.
[AGENT][NEGATIVE] No benefits are payable. They do not have the office visit benefit.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] The.
[AGENT][NEUTRAL] This claim denied on [PII].
[CUSTOMER][NEUTRAL] [PII] and the denied reason is that the office visits are not covered?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, can you send me the copy of the UBR fax?
[AGENT][NEUTRAL] Yes, may I have your fax number?
[CUSTOMER][NEUTRAL] Yes, the fax number is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] I have [PII]. I'll fax this right over. Is there anything else I can assist you with?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Right
[CUSTOMER][NEUTRAL] Yes, also provide me your name and the call reference number.
[AGENT][NEUTRAL] It will be [PII] Last initial is [PII], along with today's date will be your call reference number.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] No
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][POSITIVE] OK, got it. Thank you so much. Have a great day and bye for now.