AccountId: 011433970860
ContactId: 861b8c8f-eb47-4bdd-9e3b-6cbc74d6dcfd
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 347329 ms
Total Talk Time (AGENT): 120056 ms
Total Talk Time (CUSTOMER): 102716 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/07/861b8c8f-eb47-4bdd-9e3b-6cbc74d6dcfd_20250507T15:29_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from the fraud's office, so I need a claim status.
[AGENT][NEUTRAL] OK, I can verify claim status for you and you say your name is [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Uh, spell your name for me, please.
[CUSTOMER][NEUTRAL] It's uh it's [PII]
[AGENT][NEUTRAL] OK, thank you. And what is that policy number, please?
[CUSTOMER][NEUTRAL] Policy number is 02258742 M as in Mike L as in Lima 7.
[AGENT][POSITIVE] Thank you so much and um what is a good callback number in case the call drops?
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Callback number is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. And the patient's name, date of birth?
[CUSTOMER][NEUTRAL] Yes patient name is [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you so much and what was the date of service and amount of the charge?
[CUSTOMER][NEUTRAL] It's 900.
[CUSTOMER][NEUTRAL] $9 even.
[AGENT][NEUTRAL] What was the date of service?
[CUSTOMER][NEUTRAL] It's it's [PII].
[AGENT][NEUTRAL] OK. And do you have the balance after primary insurance has processed the claim?
[CUSTOMER][NEUTRAL] All right.
[AGENT][NEUTRAL] I'm sorry, do you have the balance after primary has processed the claim?
[CUSTOMER][NEUTRAL] Mm, yes, the balance amount is $15.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, thank you. And while I'm looking at claim information just to let you know we do have an online service center where providers can check claim status as well as print out the EOB. That site is at [PII].
[AGENT][NEUTRAL] And what is the name of the provider's office?
[CUSTOMER][NEUTRAL] OK, so before going to further, this call is being recorded for quality and training purposes. Is it OK with you?
[AGENT][NEUTRAL] Oh, that's fine.
[CUSTOMER][NEUTRAL] The provider name is Vital MD Group Holding.
[AGENT][POSITIVE] OK, thank you. Give me one moment please.
[CUSTOMER][NEUTRAL] They
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] I'm showing that claim process as office visits are not covered per the policy.
[AGENT][NEUTRAL] And give me a moment for the other charges, uh, insurance, primary insurance paid full benefits, so there's no benefits payable, and those were for the other charges.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK, so, uh, this policy office is not covered, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, so may I know the claim number for this one?
[AGENT][NEUTRAL] Sure. It's 358-0110.
[CUSTOMER][NEUTRAL] OK. So may I know your good name, please spell your name?
[AGENT][NEUTRAL] Sure, it's [PII], last initial [PII].
[CUSTOMER][NEUTRAL] OK. OK. OK. May I know the call reference number?
[AGENT][NEUTRAL] Uh, we don't give reference numbers. If you like, you may use my name at today's date.
[CUSTOMER][NEUTRAL] OK, and today's date, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So I have another patient. Can you please help me for that one?
[AGENT][NEUTRAL] Sure. Hold on one moment, please.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] OK, what is the next policy number?
[CUSTOMER][NEUTRAL] The policy number is 63Y as in Yankee 0001808.
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] Uh, no, sir. It's not one of our policy numbers. Do you have a copy of their card in front of you?
[CUSTOMER][NEGATIVE] Mm no.
[AGENT][NEUTRAL] OK. Uh, I would say you might need to contact that patient to verify their insurance. Uh, that's not our policy number.
[CUSTOMER][POSITIVE] OK, no problem. So thank you so much. So bye for now. Have a nice day. Stay safe.
[AGENT][POSITIVE] Well, you're welcome and thank you for calling APL. Bye.
[CUSTOMER][NEUTRAL] Yes bye.
[AGENT][NEUTRAL] Mhm.