AccountId: 011433970860
ContactId: 9cf6e007-b694-4711-81fc-9a6c283983d7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 266940 ms
Total Talk Time (AGENT): 64285 ms
Total Talk Time (CUSTOMER): 89360 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/20/9cf6e007-b694-4711-81fc-9a6c283983d7_20250320T20:06_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help?
[AGENT][NEUTRAL] Help you.
[CUSTOMER][NEUTRAL] Hi, hi, [PII]. Good afternoon. Um, my name is [PII] and I'm calling just to have a verification about the claim.
[AGENT][NEUTRAL] OK, [PII], I can help you with verification of uh claim status. Do you have the um a good
[AGENT][NEUTRAL] To call back number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Do you have the policy number for the patient?
[CUSTOMER][NEUTRAL] Sure. Um,
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] The policy number of the patient is, give me one.
[CUSTOMER][NEUTRAL] Yeah. 02357209.
[AGENT][NEUTRAL] OK, and what is that date of service?
[CUSTOMER][NEUTRAL] [PII] bill amount is
[CUSTOMER][NEUTRAL] The bill amount for this one is
[CUSTOMER][NEUTRAL] Give me one moment please.
[CUSTOMER][NEUTRAL] $372 even.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] Do you have the patient name and date of birth?
[AGENT][NEUTRAL] Sorry, did I already ask that.
[CUSTOMER][NEUTRAL] Sure. Um, the patient's name is [PII]. Date of birth is [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And you said 372 and who is the provider on that?
[CUSTOMER][NEUTRAL] Uh, it is.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Um, it shows here that, it shows here that, uh, we received a denial for non-covered services. I would like to know the reason behind that.
[AGENT][NEUTRAL] OK, let's see
[AGENT][NEUTRAL] Uh, it looks like the plan terminated. Let me give you that terminate.
[AGENT][NEUTRAL] date.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] Uh, the termination date
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] The eligibility date, uh, the, the, the, the enroll date.
[AGENT][NEUTRAL] Effective date was [PII].
[CUSTOMER][NEUTRAL] Ah, OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Date on [PII]. OK, got it. Should I have to bill the patient for this one?
[AGENT][NEUTRAL] Um, we don't determine patient responsibility, um, this is just a supplemental policy, so.
[CUSTOMER][NEUTRAL] So this should be as insurance, right? It, this is insurance write-off or patient responsibility?
[AGENT][NEUTRAL] We, we can't determine patient responsibility, um, we just simply will tell you if the claim has been paid or not.
[CUSTOMER][NEUTRAL] OK, got it, give me one moment please.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So, um, yeah, um, can I ask your name and the call reference number?
[AGENT][NEUTRAL] Uh, reference number will be my first name. It's [PII].
[AGENT][NEUTRAL] P H A N Y, [PII], last initial and my last name is [PII].
[AGENT][NEUTRAL] And then today's date will be the reference number so.
[AGENT][NEUTRAL] In today's date.
[CUSTOMER][POSITIVE] [PII] 2025. OK. Thank you so much for this one, [PII]. Have a great day. Bye-bye for now.
[AGENT][NEUTRAL] Oh.
[AGENT][POSITIVE] OK, thank you for calling APL. Have a good day.