AccountId: 011433970860
ContactId: a1769489-d610-498d-879c-a94fb4b1897a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 208160 ms
Total Talk Time (AGENT): 76883 ms
Total Talk Time (CUSTOMER): 77716 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/28/a1769489-d610-498d-879c-a94fb4b1897a_20250328T17:17_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] They
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Hi, this is [PII] from provider Office Orthopedics New Jersey. I want to check the claim status. Can you please assist me?
[AGENT][POSITIVE] Yeah, I'm happy to check on a claim for you today, [PII]. Do you have the patient's policy number?
[CUSTOMER][NEUTRAL] Uh yes, that is 0194078 M as in Mary, L as in Lima, number 8.
[AGENT][NEUTRAL] I'm sorry, [PII], the phone cut out. It's 019, and then can you repeat the rest?
[CUSTOMER][NEUTRAL] Uh yeah, sure. It's, uh, let me repeat. It's 01994078 M Mary, L Lima 8.
[AGENT][POSITIVE] Thank you for that. And do you have a good callback number in case we're disconnected?
[CUSTOMER][NEUTRAL] OK. That is [PII].
[AGENT][POSITIVE] Thank you so much. And then what is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] The patient name is [PII], and the date of birth is [PII].
[AGENT][NEUTRAL] All right, thank you. And then what is the date of service?
[CUSTOMER][NEUTRAL] And that is [PII]. Charge amount is $440 even.
[AGENT][NEUTRAL] [PII]. OK, one moment.
[CUSTOMER][NEUTRAL] One
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, so it looks like we did receive a claim for the state of service claim was received on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, looks like the claim was denied.
[AGENT][NEUTRAL] Uh, looks like office visits are not covered under the member's policy.
[AGENT][NEGATIVE] And the primary primary insurance didn't provide any benefits. So therefore, um, there were no benefits payable.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. And can I have the claim number?
[AGENT][NEUTRAL] That would be 357.
[AGENT][NEUTRAL] 693 2.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK, thank you so much. Can you please provide me your name and the reference number?
[AGENT][NEUTRAL] My name again is [PII], which is [PII] Call reference is my name with my last initial, which is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And then today's date.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK. Thank you so much for assisting me. Have a great day. Bye-bye.
[AGENT][NEUTRAL] You too, [PII]. Bye-bye.
[CUSTOMER][NEUTRAL] OK.