AccountId: 011433970860
ContactId: 8f0e2ce2-8502-44ab-bcdf-6d82f6b31212
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 344779 ms
Total Talk Time (AGENT): 145510 ms
Total Talk Time (CUSTOMER): 85177 ms
Interruptions: 0
Overall Sentiment: AGENT=1.5, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/06/8f0e2ce2-8502-44ab-bcdf-6d82f6b31212_20250306T13:02_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from Forefront Dermatology looking for a claim status.
[AGENT][NEUTRAL] OK, you're needing claim status, is that correct?
[CUSTOMER][POSITIVE] Yes, correct.
[AGENT][NEUTRAL] Yes, I can help you with that and could you please give me your first name again? I was not able to understand it.
[CUSTOMER][NEUTRAL] Yeah, it's [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII], OK, thank you and [PII], what is your callback number please?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, let's
[AGENT][NEUTRAL] OK, give me the phone number again, [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you. [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][POSITIVE] Yes, correct.
[AGENT][NEUTRAL] Thank you. And you have one claim to check status on R. Is that correct?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] Yes, correct.
[AGENT][NEUTRAL] OK, and what is the patient's policy number, please?
[CUSTOMER][NEUTRAL] It's 02551634.
[AGENT][POSITIVE] Thank you one moment please.
[CUSTOMER][NEUTRAL] Yeah, sure.
[AGENT][NEUTRAL] And or any information that I do provide for you today will be a verification of benefits and not a guarantee of payment. What is your patient's name please and their date of birth?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It's [PII]. Date of birth, [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Your name?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Can you spell
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] I see
[CUSTOMER][POSITIVE] See I OK, thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] And what is the date of service and total bill amount, please?
[CUSTOMER][NEUTRAL] OK. Date of service is [PII]. Bill amount for 56.21.
[AGENT][NEUTRAL] I'm sorry, give me the amount again please, Rora.
[CUSTOMER][NEUTRAL] Yeah, sure. It's 456.21.
[AGENT][NEUTRAL] 456.21.
[CUSTOMER][POSITIVE] Yes, correct.
[AGENT][POSITIVE] Thank you one moment.
[CUSTOMER][NEUTRAL] Yeah, sure.
[AGENT][NEUTRAL] And what is the name of the uh group that you're calling on behalf of?
[CUSTOMER][NEUTRAL] Forefront dermatology.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, so I do show this claim was received on [PII].
[AGENT][NEUTRAL] It was processed on [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The claim number is 3566016.
[AGENT][NEUTRAL] There was a benefit paid in the amount of $4.61.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And that was on single check 202-8739.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mm, OK.
[CUSTOMER][NEUTRAL] And what about the CPT 99214?
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] OK, so, um, just one moment, I'm sorry.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so that 99214 was denied office visits.
[AGENT][NEGATIVE] are not covered.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] By this member's policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 114.
[AGENT][NEUTRAL] And if, if you need a copy of this explanation of benefits, you may print it from our portal by going to [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, OK, thank you. And uh what will be the caller reference?
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] You would use my name along with today's date.
[CUSTOMER][POSITIVE] OK. Thank you so much for your assistance.
[AGENT][POSITIVE] Well, you're very welcome. All right. Is there anything else I can help with?
[CUSTOMER][POSITIVE] No, that's it for today. Thank you so much.
[AGENT][POSITIVE] OK. Well, you're very welcome and thank you again for calling APL. I hope you have a very nice day.
[CUSTOMER][POSITIVE] Yeah, thank you so much.
[AGENT][POSITIVE] Yes ma'am. You're welcome.
[AGENT][NEUTRAL] Bye-bye.