AccountId: 011433970860
ContactId: 961ec1a8-1c22-4637-9a2e-d8159fb74e3c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 139929 ms
Total Talk Time (AGENT): 44275 ms
Total Talk Time (CUSTOMER): 59397 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/30/961ec1a8-1c22-4637-9a2e-d8159fb74e3c_20250430T15:02_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII], this is [PII] calling from Holy Cross Medical Group. I was calling in regards to uh a claim.
[AGENT][NEUTRAL] OK, [PII], I can help you with claim status. Do you have a good callback number?
[CUSTOMER][NEUTRAL] Yes, it's a direct line. It's [PII].
[AGENT][NEUTRAL] OK, thank you. Do you have the policy number of the patient?
[CUSTOMER][NEUTRAL] Yes, I do. It is 02514338.
[AGENT][NEUTRAL] And what was that patient name and date of birth?
[CUSTOMER][NEUTRAL] Uh, the patient's name is [PII].
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And date of service and build out.
[CUSTOMER][NEUTRAL] Uh, the data service is [PII] with the bill amount of $521.
[AGENT][NEUTRAL] OK, let's see
[AGENT][NEUTRAL] Looks like we received that on [PII]. Process [PII] and let's see.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So the offices that charge is not covered under the policy.
[AGENT][NEUTRAL] And then on the second charge, like the primary insurance paid in full, so there was no benefits payable.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, got it. So, um, office visits are not covered. Now, would that be, uh, patients responsibility or is that?
[CUSTOMER][NEGATIVE] Um, like a denial.
[AGENT][NEUTRAL] Um, well, we, since we're, since we're secondary, we can't determine patient responsibility on the policy. Um, we can, we just process according to what the policy states, so.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, got it. Alrighty. Thank you so much for all of your help.
[AGENT][POSITIVE] OK, thanks for calling APL. I hope you have a good day.
[CUSTOMER][NEUTRAL] You as well bye bye.