AccountId: 011433970860
ContactId: 992bfa43-3707-4989-86a7-d9960dc2113b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 346220 ms
Total Talk Time (AGENT): 153748 ms
Total Talk Time (CUSTOMER): 109747 ms
Interruptions: 2
Overall Sentiment: AGENT=0.9, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/05/992bfa43-3707-4989-86a7-d9960dc2113b_20250605T17:59_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APO. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Thank you so much for that. Hi, my first name is [PII], initiated the last name, [PII], calling from provider office Neurospine Institute spine and Orthopedic center and want to discuss claim. Actually, I have only one claim, please.
[AGENT][NEUTRAL] OK, and I'm sorry, what was your first name again?
[CUSTOMER][NEUTRAL] [PII] last [PII], [PII] yes.
[AGENT][NEUTRAL] [PII]. OK. [PII]
[AGENT][POSITIVE] OK, thank you, [PII].
[CUSTOMER][NEUTRAL] No, no, no. [PII].
[CUSTOMER][NEUTRAL] Starting with [PII]
[AGENT][NEUTRAL] OK. Thank you. [PII], is that correct?
[CUSTOMER][NEUTRAL] Yes. Could you kindly spell your good name for me, please, first?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] It's gonna be [PII]. Is that correct?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][POSITIVE] OK, thank you so much for that clarification.
[AGENT][NEUTRAL] You're welcome. And [PII], what is your callback number?
[CUSTOMER][NEUTRAL] Yes. [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Extension number is [PII].
[AGENT][NEUTRAL] Thank you. And you said that you have one claim to check status on, is that correct?
[CUSTOMER][NEUTRAL] Yes, yes, only one client.
[AGENT][NEUTRAL] Yes, sir. I can help you with that. And what is the patient's policy number?
[CUSTOMER][NEUTRAL] Yes, Patient ID number is 60801.
[AGENT][NEUTRAL] OK, that is our electronic payer ID on me. That is not the member's policy number.
[CUSTOMER][NEUTRAL] Uh, just a.
[CUSTOMER][NEUTRAL] Just a moment, I verify.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Yes, policy ID number is 024879974.
[AGENT][NEUTRAL] OK thank you one moment please.
[CUSTOMER][POSITIVE] OK. Take your time, please. Thank you so much for that.
[AGENT][POSITIVE] You're, you're welcome.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] And [PII], again, any information that is provided will be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] Thank you so much for that. Patient first name is [PII]. Last name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you. And the date of service and total bill amount.
[CUSTOMER][NEUTRAL] Yes, uh, uh, [PII] total charge amount is $1,238 even and want to discuss general claim status please?
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] You're needing claim status, is that correct?
[CUSTOMER][NEUTRAL] Yes, general claim status.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, one moment please.
[CUSTOMER][POSITIVE] Take your time, please.
[AGENT][NEUTRAL] OK, so this claim was received.
[AGENT][NEUTRAL] The received date was on [PII].
[AGENT][NEUTRAL] It was processed on [PII].
[AGENT][NEUTRAL] The claim number is 359-932-7.
[AGENT][NEUTRAL] There was a benefit paid in the amount of $25.17.
[AGENT][NEUTRAL] That was paid on single check 204.
[AGENT][NEUTRAL] 344 6.
[CUSTOMER][POSITIVE] Thank you so much for that.
[AGENT][NEUTRAL] Uh, mhm.
[AGENT][NEUTRAL] And, um, the remarks on this claim?
[CUSTOMER][NEUTRAL] And
[AGENT][NEUTRAL] For 99213 that was denied because office visits are not covered by this policy. The member supplemental policy does not cover office visits.
[CUSTOMER][NEUTRAL] The member supplement policy.
[AGENT][NEUTRAL] Mhm, does not cover office visits.
[CUSTOMER][NEGATIVE] Not cover
[CUSTOMER][POSITIVE] OK, thank you so much for that. May I have your reference number for this call, please?
[AGENT][NEUTRAL] Yes, you will actually use my name and today's date and then if you need a copy of this O me, if you need a copy of that explanation of benefits you can use that claim number by going to our portal which is located at [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And you should be able to print a copy of it for yourself.
[CUSTOMER][POSITIVE] OK. Thank you so much for that. That's all from my side. Have a wonderful day. Bye for now. Stay safe. Have again. Thank you, bye.
[AGENT][POSITIVE] Well, you're welcome. Yes.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Well, I have, yes, sir. Uh, well, thank you for calling APL on me. It was my pleasure in speaking to you and I hope you have a nice afternoon also.
[CUSTOMER][NEUTRAL] Bye.
[AGENT][NEUTRAL] Bye-bye.