AccountId: 011433970860
ContactId: 999e5f04-9ad2-484c-8c5f-a26308d22f2d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 312779 ms
Total Talk Time (AGENT): 134014 ms
Total Talk Time (CUSTOMER): 104829 ms
Interruptions: 1
Overall Sentiment: AGENT=2.2, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/24/999e5f04-9ad2-484c-8c5f-a26308d22f2d_20250324T14:43_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hello, [PII]. My name is [PII]. Last name initial is [PII].
[CUSTOMER][NEUTRAL] I'm calling from provider's office to check on a claim.
[AGENT][POSITIVE] It would be my pleasure to assist you. Can you spell your name, please?
[CUSTOMER][NEUTRAL] It's going to be [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you, [PII], and a callback number, please.
[CUSTOMER][NEUTRAL] It is [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] And [PII], this will be a direct line. There will be no extension on it.
[AGENT][NEUTRAL] Thank you, [PII]. And [PII], what is the policy number for the patient, please?
[CUSTOMER][NEUTRAL] It is 023.
[CUSTOMER][NEUTRAL] 56413
[AGENT][NEUTRAL] Thank you, [PII]. And what is the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] It's gonna be [PII] with the date of birth of [PII].
[AGENT][POSITIVE] All right, thank you, and it would be my pleasure to assist you with that claim status and [PII], do you have a claim number or date of service?
[CUSTOMER][NEUTRAL] We did a service since [PII].
[CUSTOMER][NEUTRAL] Total charge amount is $377 even.
[AGENT][NEUTRAL] And you said that date of service is [PII]?
[CUSTOMER][POSITIVE] That is correct.
[AGENT][NEUTRAL] Alright, [PII], if you will bear with me just one moment, the policy number you gave me actually turned on 10-124. I'm checking to see if she has active coverage for that data service of December.
[AGENT][NEUTRAL] 1024. Bear with me just one second.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And [PII], I did find a policy with active coverage for that data service. Can I give you the correct policy number?
[CUSTOMER][POSITIVE] Yeah, I'm ready for it.
[AGENT][NEUTRAL] As of 10-1-2024, the active policy number is 25,510.
[AGENT][NEUTRAL] 29.
[CUSTOMER][NEUTRAL] The number.
[AGENT][NEUTRAL] And [PII], I can, I do have a claim on file for that data service. What is the bill amount, please?
[CUSTOMER][NEUTRAL] It is $377 even.
[AGENT][NEUTRAL] And what is the facility name?
[CUSTOMER][NEUTRAL] It's gonna be Pioneer Physicians Network.
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] And [PII], I am showing that we received that claim on [PII].
[AGENT][NEUTRAL] 25 and processed on [PII].
[AGENT][NEUTRAL] Now, the office visit?
[AGENT][NEUTRAL] The
[AGENT][NEUTRAL] 99214 was denied as office visits are not covered under the patient's plan.
[AGENT][NEUTRAL] And then all the proceeding codes are denied as services are not covered when performed in a doctor's office.
[CUSTOMER][NEUTRAL] This is.
[CUSTOMER][NEUTRAL] This is the code um north of uh.
[CUSTOMER][NEUTRAL] May I get to know the patient plan name as well?
[AGENT][NEUTRAL] It is a secondary gap policy. It's Medlink gap.
[CUSTOMER][POSITIVE] Oh, I'm really sorry. Could you repeat once again, please?
[AGENT][NEUTRAL] It's Medlink M E D L I N K GA G A P.
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] OK, and as for the patient's plan, uh, offices codes are not covered under the patient's plan, am I right?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] Um, [PII], may I get to know the team number as well?
[AGENT][NEUTRAL] Claim number is 355.
[AGENT][NEUTRAL] 952-2.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And just to confirm for the documentation purpose.
[CUSTOMER][NEUTRAL] Please spell out your name like this, right? That will be [PII].
[AGENT][POSITIVE] Yes, sir, that's correct.
[CUSTOMER][NEUTRAL] And may I get another reference number for this call?
[AGENT][NEUTRAL] The reference number is my name and today's date.
[AGENT][POSITIVE] And it has been a pleasure to assist you with that claim status. [PII], is there anything else I can help you with today?
[CUSTOMER][POSITIVE] Not something else, but thank you so much, [PII], for your assistance.
[AGENT][POSITIVE] And thank you for calling APL. I hope you have a wonderful day.
[CUSTOMER][POSITIVE] Thank you so much, [PII]. You too. Have a great day. Bye-bye.
[AGENT][POSITIVE] Thank you. Bye-bye.