AccountId: 011433970860
ContactId: a6740886-853a-4bfe-994d-5909bfa4700c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 330980 ms
Total Talk Time (AGENT): 78830 ms
Total Talk Time (CUSTOMER): 86897 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=-0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/03/a6740886-853a-4bfe-994d-5909bfa4700c_20250403T17:37_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII]. And I'm calling for a provider to check on additional information about a claim that has Monday night. Please note this call will be monitored and recorded for quality and training purposes. Good afternoon. How are you doing today, [PII]?
[AGENT][NEUTRAL] Oh
[AGENT][POSITIVE] I'm doing good, [PII]. How are you doing today?
[CUSTOMER][POSITIVE] I'm doing fine, thanks for asking.
[AGENT][NEUTRAL] Can I please get your callback number, sir, just in case the call gets disconnected?
[CUSTOMER][NEUTRAL] Yes, the callback number is [PII] and it is the direct line.
[AGENT][NEUTRAL] Thank you, sir. And then what's the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] All right. First I'll start with the policy number which is 02565754.
[CUSTOMER][NEUTRAL] And the number is Yvette May.
[CUSTOMER][NEUTRAL] And date of birth, [PII].
[AGENT][NEUTRAL] OK, let me pull up that policy real quick.
[CUSTOMER][NEUTRAL] All right.
[AGENT][NEUTRAL] OK, and then what is the date of service for the member and the charge amount?
[CUSTOMER][NEUTRAL] Data service on [PII]. Total bill amount is $432 even.
[AGENT][NEUTRAL] OK, and you said that day was [PII] or [PII]?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] 30, OK. And then can you give me the charge amount after the primary insurance paid their part?
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Uh, it is 50 $55 even.
[AGENT][NEUTRAL] 55 even, OK, and what is the name of the facility you're calling from?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] The facility is orthopedic Center of Palm Beach County LLC.
[AGENT][NEUTRAL] OK, I'm gonna put you on a brief hold, [PII], while I look at this claim for us and I'll be right back.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] All right. Take your time.
[AGENT][POSITIVE] Thank you, sir.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Hm.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK [PII], thank you very much for holding for me so I have the claim pulled up um the claim number is 374749. The claim was denied because office visits are not covered under the patient's policy.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] Hopes are not covered by the patient's policy. Thank you very much for that information. And may I know the patient's plan type for my documentation?
[AGENT][NEUTRAL] The plan type, is that what you said?
[CUSTOMER][NEUTRAL] Mm yes.
[AGENT][NEUTRAL] Yes, sir. It's [PII]
[CUSTOMER][NEUTRAL] [PII]. Thank you. And may I have a reference number for our call?
[AGENT][NEUTRAL] Yes, you can use my name [PII] and today's date.
[CUSTOMER][POSITIVE] Got it. OK. Then that would be all. Have a great day and take care. Bye for now.
[AGENT][POSITIVE] You too, [PII]. You have a great day too. Thanks for calling APL. Bye-bye, sir.
[CUSTOMER][NEUTRAL] OK