AccountId: 011433970860
ContactId: 86d4bdc1-1ec8-4d07-b95f-28bc9fa00a06
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 257839 ms
Total Talk Time (AGENT): 75433 ms
Total Talk Time (CUSTOMER): 84751 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/21/86d4bdc1-1ec8-4d07-b95f-28bc9fa00a06_20250421T13:01_UTC.wav
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[AGENT][NEUTRAL] For calling APL, this is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi [PII]. Hi [PII] provider's office. Could you please
[AGENT][NEUTRAL] I barely hear you.
[CUSTOMER][NEUTRAL] Hello, my name is [PII]. I'm calling from provider's office. Are you able to hear me?
[AGENT][POSITIVE] Yes, I can hear you now, [PII]. Thank you. How can I assist you today?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Yeah, could you please help me with the claim?
[AGENT][NEUTRAL] Sure, I can assist you with that, [PII]. Can I have a callback number for you and that policy number?
[CUSTOMER][NEUTRAL] Yeah, the callback number is [PII].
[AGENT][NEUTRAL] [PII], I can barely hear you.
[CUSTOMER][NEUTRAL] Yeah, so sorry, the claim num the callback number is [PII].
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] May I get your name, please?
[AGENT][NEUTRAL] My name is [PII]. And [PII], what is the policy number of the member that you're calling to check the status of a claim for today?
[CUSTOMER][NEUTRAL] Spells.
[CUSTOMER][NEUTRAL] Uh, sorry, what did you ask?
[AGENT][NEUTRAL] What is the policy number of the member that you're calling to check the status of a claim for today?
[CUSTOMER][NEUTRAL] Yes, the policy number is
[CUSTOMER][NEUTRAL] 01792127.
[AGENT][NEUTRAL] Can you verify that patient's name and date of birth, and I'll be able to assist you.
[CUSTOMER][NEUTRAL] Uh yeah. The patient name I have is [PII]. Date of birth [PII].
[AGENT][NEUTRAL] And what is the date of service that you're calling to check the status of a claim for?
[CUSTOMER][NEUTRAL] Uh, the date of service is [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And what is your procedure code, [PII]?
[CUSTOMER][NEUTRAL] Uh, there are multiple procedure codes, but my claim is denied only for one code.
[CUSTOMER][NEUTRAL] It is 87038.
[CUSTOMER][NEUTRAL] The total charge amount is $409.43.
[AGENT][NEUTRAL] For DME coverage.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEGATIVE] So look like the procedure code was denied because it's disposable. The policy does not cover disposable items.
[CUSTOMER][NEUTRAL] Just give me a moment.
[CUSTOMER][NEUTRAL] Uh, so members plan does not cover the item, right?
[AGENT][NEUTRAL] Correct, disposable items are not covered on the DME coverage.
[CUSTOMER][NEUTRAL] OK. Can you please tell me the patient's plan name?
[AGENT][NEUTRAL] The patient's plan's name is a medlink gap plan. This is not a primary insurance company.
[CUSTOMER][NEUTRAL] Medlink gap plan, right?
[AGENT][POSITIVE] Yes, that is correct.
[CUSTOMER][POSITIVE] Thank you so much. Could you please uh give me the claim number?
[AGENT][NEUTRAL] The claim number is 357-8805.
[CUSTOMER][NEGATIVE] And then I don't wish it.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Thank you so much. Could you provide me the call reference number?
[AGENT][NEUTRAL] We don't provide those, however, you can use my name and today's date as a reference, [PII].
[AGENT][NEUTRAL] Would you like for me to provide you with my name and the date again?
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] No, no, that's it. Thank you. Have a good day.
[AGENT][POSITIVE] Thanks for calling APL and have a great day.