AccountId: 011433970860
ContactId: 8a5d601d-c7cd-46b6-922c-0e8b948d4838
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 182669 ms
Total Talk Time (AGENT): 100537 ms
Total Talk Time (CUSTOMER): 49579 ms
Interruptions: 0
Overall Sentiment: AGENT=2, CUSTOMER=1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/17/8a5d601d-c7cd-46b6-922c-0e8b948d4838_20250217T16:12_UTC.wav
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[AGENT][POSITIVE] Morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. This is [PII] with UVA physicians Group. I need to check the status of a claim for a patient, please.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] [PII], it would be a pleasure to help you with that claim status today. What is a good callback number?
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] Thank you, [PII]. And what is the policy number for the patient, please?
[CUSTOMER][NEUTRAL] That is 02287984.
[AGENT][NEUTRAL] Thank you, [PII] and the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] [PII] and the date of birth is [PII].
[AGENT][POSITIVE] Alright, thank you, and as I said, it would be a pleasure to assist you with that claim status for [PII]. What is that data service?
[CUSTOMER][NEUTRAL] The date of service is [PII].
[AGENT][NEUTRAL] And what is that bill amount please ma'am?
[CUSTOMER][NEUTRAL] $351.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And the facility name?
[CUSTOMER][NEUTRAL] University of Virginia physicians group.
[AGENT][POSITIVE] All right, thank you, that's GVA correct.
[CUSTOMER][POSITIVE] Yes ma'am, I'm sorry.
[AGENT][POSITIVE] All right, thank you, no problem. I figured it was UVA.
[AGENT][NEUTRAL] I can help you with that claim status. [PII]. I'm showing that we received that claim on [PII].
[AGENT][NEUTRAL] And it was processed on [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Claim number 354.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 8125.
[AGENT][NEUTRAL] The 99214 was denied as office visits are not covered under the patient's plan.
[AGENT][NEUTRAL] And the 99,000 was denied as benefits are payable only if the major medical provides benefits.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so the member is responsible.
[AGENT][NEUTRAL] If if the primary did not apply anything to the deductible copay or coinsurance for that procedure, then there would be no benefits payable from APL.
[CUSTOMER][NEUTRAL] Alrighty, and is there a reference number for today?
[AGENT][NEUTRAL] Reference number is my name and today's date. I spell my name [PII].
[CUSTOMER][POSITIVE] All right, [PII], thank you so much.
[AGENT][POSITIVE] Well thank you for calling APL. It's been a pleasure to assist you with that claim status, and I hope you have a wonderful day.
[CUSTOMER][POSITIVE] You as well. Thank you.
[AGENT][POSITIVE] Thank you, [PII]. Bye-bye.
[CUSTOMER][NEUTRAL] Bye-bye.