AccountId: 011433970860
ContactId: 9e4f1977-84b7-4ed9-b550-c005205039bb
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 178690 ms
Total Talk Time (AGENT): 83760 ms
Total Talk Time (CUSTOMER): 54061 ms
Interruptions: 1
Overall Sentiment: AGENT=2.4, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/06/9e4f1977-84b7-4ed9-b550-c005205039bb_20250206T15:54_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] Uh hello, this is [PII]. Last name is [PII]. I'm calling from To office looking for claim status.
[AGENT][POSITIVE] It would be my pleasure to assist you with claim status, [PII]. What is the callback number?
[CUSTOMER][NEUTRAL] Yeah, it's [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, [PII], and what is the policy number for the patient, please?
[CUSTOMER][NEUTRAL] 01867033 M as in Mary, L as in Lima, 8.
[AGENT][NEUTRAL] Thank you. And the patient's name and date of birth, please, sir?
[CUSTOMER][NEUTRAL] Yeah, the patient name is going to be [PII]. Date of birth is [PII].
[AGENT][POSITIVE] Alright, thank you. It would be my pleasure to help you with that claim status. What is the data service?
[CUSTOMER][NEUTRAL] Data service [PII] with total charges.
[CUSTOMER][NEUTRAL] Going to be $340 even.
[AGENT][POSITIVE] Thank you. And what is the facility name, please?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Facility name is gonna be correct vision.
[CUSTOMER][NEUTRAL] Laser Institute.
[AGENT][NEUTRAL] Thank you, [PII]. [PII], we did receive that claim on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It was processed on [PII].
[AGENT][NEUTRAL] Now this claim was denied as office visits are not covered per the patient's plan.
[CUSTOMER][NEUTRAL] Offices are not covered, so it is patient responsibility.
[AGENT][NEUTRAL] we don't determine patient responsibility. We're not major medical. We are secondary to the primary insurance. Patient responsibility would be determined by the provider.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] Now we did receive the claim again and it was processed as a duplicate and I can provide that information as well if needed.
[CUSTOMER][NEGATIVE] OK, so you guys are not going.
[CUSTOMER][NEUTRAL] Uh, no worries. Could you please just help me with the claim number?
[AGENT][NEUTRAL] The original claim number is 355.
[AGENT][NEUTRAL] 6711
[CUSTOMER][NEUTRAL] OK, so the, uh, OK.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK. Thank you, sir. I didn't get your name. Your name is?
[AGENT][NEUTRAL] [PII]. If you need a reference number, [PII], it would be my name and today's date.
[AGENT][POSITIVE] And it has been a pleasure to assist you with that claim status. Anything else I can help you with?
[CUSTOMER][POSITIVE] I know, thank you so much. That's all on the side. You have a wonderful day. bye bye.
[AGENT][POSITIVE] And thank you for calling. Hope you have a wonderful day as well, [PII]. Thank you for calling APL. Take care.