AccountId: 011433970860
ContactId: 87b8087e-0fdd-4ea8-9fb7-17527e49c3d3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 280000 ms
Total Talk Time (AGENT): 89962 ms
Total Talk Time (CUSTOMER): 117160 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/14/87b8087e-0fdd-4ea8-9fb7-17527e49c3d3_20250214T17:39_UTC.wav
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[AGENT][NEUTRAL] Good morning. [PII]. This is speaking. May I help you?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Hi, um, my name is [PII], like the state, I'm calling from a line health business office. This call may be recorded for quality and training. I just need to see if you received the claim and if there's any claim or payment status on it.
[AGENT][NEUTRAL] OK, well I can verify claim status, Ms. [PII], and what's that policy number, please?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I have um 024939999.
[AGENT][NEUTRAL] OK, and let's see.
[AGENT][NEUTRAL] And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] do you
[CUSTOMER][NEUTRAL] Yeah, [PII].
[CUSTOMER][NEUTRAL] What was your name again? I'm sorry I missed it at the beginning of the call.
[AGENT][NEUTRAL] Uh, [PII]
[CUSTOMER][NEUTRAL] I
[CUSTOMER][POSITIVE] Thank you, and mine's [PII] if you need it.
[AGENT][NEUTRAL] You
[AGENT][NEUTRAL] OK, and Ms. [PII], do you have, uh, what's the patient's name, date of birth?
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] It's [PII], [PII].
[AGENT][NEUTRAL] OK, and what was the date of service and amount of the charge?
[CUSTOMER][NEUTRAL] It's um [PII] for $720 even.
[AGENT][NEUTRAL] Alright.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And let's see.
[AGENT][NEUTRAL] 822. And do you have the amount, uh, well, no, there's no primary. Give me one moment.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] And you're calling from?
[CUSTOMER][NEUTRAL] A line of health business office.
[AGENT][NEUTRAL] OK, I do show it received the claim and it looks like it processed as uh vaccination immunizations are not covered on the policy.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, hang on one sec.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, um, do you have like a claim number that denied under?
[AGENT][NEUTRAL] Uh yes, ma'am. It's 352.
[CUSTOMER][NEUTRAL] That
[AGENT][NEUTRAL] 7232.
[CUSTOMER][NEUTRAL] And what when what was the date that it actually denied for the uh not non-covered?
[AGENT][NEUTRAL] Uh, [PII] of last year.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So I mean basically it's patient responsibility since that's not a covered a service.
[AGENT][NEUTRAL] Uh, yes, ma'am.
[CUSTOMER][NEUTRAL] And would that be for the whole 7/20 or did y'all do any kind of like disallowed or adjustments?
[AGENT][NEUTRAL] Uh, we don't reprice or this or make any adjustments. It's just, uh, not covered. Yes, ma'am.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, just a non-covered. So we did not receive that remit. Is there a way that we can get that? Are you able to fax it?
[AGENT][NEUTRAL] Yes, ma'am. What's your fax number?
[CUSTOMER][POSITIVE] Oh great OK it is.
[CUSTOMER][NEUTRAL] [PII] and you can just put attention [PII].
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, and that's [PII]?
[CUSTOMER][NEUTRAL] Yeah, that's it.
[AGENT][POSITIVE] OK. I will fax it to you hopefully in a few moments.
[CUSTOMER][NEUTRAL] OK, [PII], when you get a chance, can I just get a call reference number and that'll do it.
[AGENT][NEUTRAL] Um, we don't give reference numbers, but you may use my name in today's date.
[CUSTOMER][NEUTRAL] I just didn't
[CUSTOMER][NEUTRAL] Yeah, I'll do that then.
[CUSTOMER][POSITIVE] Awesome.
[AGENT][NEUTRAL] And I will fax it over, um, in a few moments.
[AGENT][NEUTRAL] 43. OK. And is there anything else I can assist you with today, Ms. [PII]?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] No, that's it. I hope you have a great day and happy [PII] to you.
[AGENT][POSITIVE] Uh, you too and happy [PII].
[CUSTOMER][POSITIVE] OK thanks bye bye.
[AGENT][NEUTRAL] Mm mm bye.