AccountId: 011433970860
ContactId: 86e2c869-0ea9-4277-b8e6-933cbceaccb9
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 282859 ms
Total Talk Time (AGENT): 87769 ms
Total Talk Time (CUSTOMER): 103027 ms
Interruptions: 1
Overall Sentiment: AGENT=0.4, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/22/86e2c869-0ea9-4277-b8e6-933cbceaccb9_20250522T21:20_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Hi, [PII], this is I'm calling on behalf of products office to check on a claim status.
[AGENT][NEUTRAL] OK, I can verify claim status for you and your name is?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and [PII], what is the policy number, please?
[CUSTOMER][NEUTRAL] Yeah, it would be 02483111.
[AGENT][NEUTRAL] I'm sorry, say that again.
[CUSTOMER][NEUTRAL] 02 4
[CUSTOMER][NEUTRAL] 83111.
[AGENT][NEUTRAL] OK, thank you. One moment. And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] Sure, it's [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and verify the patient's name, date of birth.
[CUSTOMER][NEUTRAL] Yes [PII] and the date of birth would be [PII].
[AGENT][NEUTRAL] OK, and what was the date of service and the amount of the charge?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] It's [PII] and charge with $386. 40 cents.
[AGENT][NEUTRAL] And the balance after primary?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] It would be $60.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] You said the date to start [PII] of this year?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] OK, and what is the name of the provider's office?
[CUSTOMER][NEUTRAL] Yeah, that's
[CUSTOMER][NEUTRAL] Sleep, snoring and sinus clinic of Florida.
[AGENT][NEUTRAL] OK, and while I'm looking up claim information, let you know we do have an online uh service center where providers can check claim status as well as print out the EOB. That site is at [PII].
[AGENT][NEUTRAL] And I show the claim process as office visits are not covered per the policy.
[CUSTOMER][NEUTRAL] OK. So office visits are usually a general visit, right? So it should be covered.
[AGENT][NEUTRAL] No, because it's not covered on the patient's policy with our company.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Well, so what are all the visits are covered for this patient then?
[AGENT][NEUTRAL] Uh, the policy covers services performed in an outpatient facility or inpatient in hospital.
[CUSTOMER][NEUTRAL] Only the outpatient or inpatient in the hospital are covered, not in the office business, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] Yeah, so I think it's a general basics for the office, so it should be get covered.
[AGENT][NEUTRAL] No, sir, it's not covered under their policy. Whether you think or a primary think it's not covered on their policy with our company.
[CUSTOMER][NEUTRAL] I got that.
[CUSTOMER][NEUTRAL] Uh, got it.
[CUSTOMER][NEUTRAL] Just give me a second. I'm just documenting those things.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][POSITIVE] Well, thank you so much for waiting online and
[CUSTOMER][NEUTRAL] Could you please ask me the UB?
[AGENT][NEUTRAL] Sure, what is the fax number?
[CUSTOMER][NEUTRAL] Mm, yeah, it's um [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and that's [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, and is there anything else I can assist you with today, [PII]?
[CUSTOMER][NEUTRAL] Mm, I don't think I already got each and every detail. I just want to verify this.
[AGENT][POSITIVE] OK, uh, thank you for calling APL and you have a great day.
[CUSTOMER][NEUTRAL] Uh, and when can I receive the UV?
[AGENT][NEUTRAL] It'll be sent in a few moments.
[CUSTOMER][POSITIVE] Well, thank you so much for that and have a pretty good day. Bye-bye.
[AGENT][NEUTRAL] Mhm bye.