AccountId: 011433970860
ContactId: 9a3419ef-b696-4c35-8156-04e3e510d260
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 313739 ms
Total Talk Time (AGENT): 90666 ms
Total Talk Time (CUSTOMER): 232814 ms
Interruptions: 3
Overall Sentiment: AGENT=0.2, CUSTOMER=1.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/13/9a3419ef-b696-4c35-8156-04e3e510d260_20250213T22:51_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Hi this is [PII] calling you from Westminster general office. How are you today?
[AGENT][NEUTRAL] I am fine, and I apologize, your name is again? You said [PII]?
[CUSTOMER][NEUTRAL] [PII] [PII], yes, and I'm sorry, what is your?
[AGENT][NEUTRAL] [PII] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Thank you [PII] mhm.
[CUSTOMER][NEUTRAL] And [PII], I just tried to check um um explanation on denial on a claim please.
[AGENT][NEUTRAL] OK, and what's that policy number, please?
[CUSTOMER][NEUTRAL] And that is 02537595. Patient name is [PII].
[AGENT][NEUTRAL] OK, and uh verify her date of birth.
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] OK, and Ms. [PII], do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] OK, and what was the date of service and amount of the charge?
[CUSTOMER][NEUTRAL] And that is for uh let me see, [PII] and I sent my claim for 127 well I'm sorry it's 299. I'm sorry, that's 299 mhm.
[AGENT][NEUTRAL] OK, one moment, please.
[AGENT][NEUTRAL] 299.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, see.
[AGENT][NEUTRAL] Where you're calling from?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] From Doctor [PII].
[AGENT][NEUTRAL] 74.
[CUSTOMER][NEUTRAL] So I think at that time I was just like I just couldn't, I mean.
[CUSTOMER][NEUTRAL] He's so great, but I was, I think I just had to participate in that way. So actually reading that now I'm like it just makes me happy, but um.
[CUSTOMER][NEUTRAL] Isn't that yeah.
[AGENT][NEUTRAL] Um, what were the what were the procedures because I see there was a claim for that data service twice.
[CUSTOMER][NEUTRAL] That's
[CUSTOMER][NEGATIVE] Yeah, or twice, uh, I still have my pending, so I haven't received any. That was for the limited exam and an X-ray and to, uh, one by one and then 2 PAs. The patient came out with with pain, but, uh, when I sent my claim it was supposed to be covered for for preventive and basic only.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, let me see.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Yeah, isn't it beautiful, yeah.
[CUSTOMER][NEUTRAL] Well, I was gonna talk to you about it, so, um.
[AGENT][NEUTRAL] Mm, let me one moment to pull up this claim.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I don't but I can give us that answer.
[CUSTOMER][POSITIVE] Yes, let me do what we can and then after that then I have to go to yeah we got a machine where always wanted it, so.
[CUSTOMER][POSITIVE] Because before we used to do it out out to send people out for that and now we do it.
[CUSTOMER][NEUTRAL] right now.
[CUSTOMER][NEUTRAL] But I just, I just, yeah, yeah, maybe you just do it here. No, no, no, yeah, yeah, we do it here and then we'll be able to tell you, um.
[AGENT][NEGATIVE] OK, I show that claim, um, looks like it was received twice. Uh, the first time we paid $60.66 dollars 60 cents. Uh, the second time it was processed as a duplicate, and the initial claim, go ahead, I'm sorry.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I see
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Did you show also that uh uh Kiki if that check is clear because I still have that pending in my system.
[AGENT][NEUTRAL] Uh, let me see.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] so that I can.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] and I, I, I don't wanna wait on it, you know, so, um, I will work on it. Thank you. Thank you for the for the restaurant. Oh yeah, you let me know I will. Alright, bye.
[AGENT][POSITIVE] Uh, it's still showing outstanding.
[CUSTOMER][NEUTRAL] Hi
[AGENT][NEUTRAL] It looks like it was
[CUSTOMER][NEUTRAL] Would you, would you be able to reissue a new one?
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] I'll send a request to have it um to verify if it's clear or not. If not, then they can void and reissue.
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] Uh huh
[CUSTOMER][POSITIVE] Yes please.
[AGENT][NEUTRAL] OK. And is there anything else I can assist you with today, Ms. [PII]?
[CUSTOMER][POSITIVE] No, no, that's it. I, I thank you much for your help and time and you have a wonderful rest of the day. So just should I give him a couple of, uh, like 10 days or so?
[AGENT][NEUTRAL] Alright.
[AGENT][NEUTRAL] Uh yes, ma'am.
[CUSTOMER][POSITIVE] OK, alright, thank you, [PII], for your time, mhm.
[AGENT][POSITIVE] Uh, you're welcome. Thank you for calling APL. You have a great day.
[CUSTOMER][POSITIVE] You're welcome you too bye bye.
[AGENT][NEUTRAL] Bye.