AccountId: 011433970860
ContactId: 8aa8b577-722b-49d5-a322-2e4f2439c44e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 274230 ms
Total Talk Time (AGENT): 98350 ms
Total Talk Time (CUSTOMER): 59361 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/05/8aa8b577-722b-49d5-a322-2e4f2439c44e_20250305T22:25_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi, um, I'm calling from a provider's office regarding a denied claim, please.
[AGENT][NEUTRAL] OK, I can verify claim status for you and your name is?
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] I'm sorry, your phone cut out. Say again?
[CUSTOMER][NEUTRAL] It's [PII]
[AGENT][NEUTRAL] OK, and Ms. [PII], what is that policy number, please?
[CUSTOMER][NEUTRAL] Oh sure sorry let me get that.
[CUSTOMER][NEUTRAL] 021 3
[CUSTOMER][NEUTRAL] 889 8.
[AGENT][NEUTRAL] OK, thank you. And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you. And verify the patient's name, date of birth.
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] OK. And what was the date of service and the amount of the charge?
[CUSTOMER][NEUTRAL] It was [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And it denied as as I'm sorry, it denied us a duplicate which we had resubmitted for the patient's request um he said he had cleared something up with you guys.
[CUSTOMER][NEUTRAL] Um, so I wasn't sure it was processed or.
[AGENT][NEUTRAL] And
[CUSTOMER][NEUTRAL] He didn't say too much.
[AGENT][NEUTRAL] Give me one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And you're calling from?
[CUSTOMER][NEUTRAL] The University of Colorado Medicine.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] Uh, it looks like a process is not covered.
[AGENT][NEGATIVE] Loss on the plan.
[AGENT][NEUTRAL] This for an office visit?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] H.
[AGENT][NEUTRAL] Give me one moment.
[AGENT][POSITIVE] Vitro words to heart, and adhesion right eye.
[AGENT][NEUTRAL] Uh, 3531.
[AGENT][NEUTRAL] What is this non.
[AGENT][NEUTRAL] Like, oh, yeah, it looks like it's, well what that code is, but it doesn't look like it's covered under the policy. Well, the policy doesn't cover for office visits as a secondary supplemental plan, uh, covers services in an outpatient facility or inpatient in a hospital, but not office visits.
[CUSTOMER][NEUTRAL] OK, got you.
[AGENT][NEUTRAL] Uh, let's see, OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It looks like the initial claim was received on.
[AGENT][NEUTRAL] [PII] process on [PII].
[AGENT][NEUTRAL] Excuse me.
[CUSTOMER][NEUTRAL] OK, um, could I just have a call reference number when you're ready?
[AGENT][NEUTRAL] Uh, we don't give reference numbers, but if you like, you may use my name it's [PII].
[CUSTOMER][NEUTRAL] OK, and I'm sorry I missed your name.
[AGENT][NEUTRAL] It's [PII], last initial [PII].
[CUSTOMER][POSITIVE] OK, sounds good thank you so much for your help.
[AGENT][POSITIVE] Uh, yes, ma'am. Thank you for calling APL. Have a great day, Ms. [PII].
[CUSTOMER][NEUTRAL] You too bye bye.