AccountId: 011433970860
ContactId: a9a5840b-d8ca-47b4-9907-b4eeed8f2cdc
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 598729 ms
Total Talk Time (AGENT): 114652 ms
Total Talk Time (CUSTOMER): 208995 ms
Interruptions: 4
Overall Sentiment: AGENT=0.7, CUSTOMER=-0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/11/a9a5840b-d8ca-47b4-9907-b4eeed8f2cdc_20250311T14:07_UTC.wav
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[AGENT][POSITIVE] Thank you for calling. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Hi, my name is [PII] calling from the provider's office to check on a claim status.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] OK, I can help you with claim status. [PII]. Can I please get your call back number just in case our call is disconnected.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yes, just a moment. The callback number is [PII].
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] Thank you and what is the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] The patient's policy number is 944275. And the patient's last name is [PII] and the patient's first name is [PII] And the date of birth is [PII].
[CUSTOMER][NEUTRAL] It
[AGENT][NEUTRAL] OK, let me pull up that policy real quick.
[CUSTOMER][NEUTRAL] Sorry, can you repeat one second?
[AGENT][NEUTRAL] Yes, but I've got [PII] and um.
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] Can you give me the date of service and the charge amount?
[CUSTOMER][NEUTRAL] Really
[CUSTOMER][NEUTRAL] OK. The date of service is [PII] and the charge amount is $174.
[CUSTOMER][NEGATIVE] it's ridiculous.
[AGENT][NEUTRAL] OK, and then what's the charges after the primary insurance paid their part?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Sorry, can you repeat once again?
[AGENT][NEUTRAL] What is large amount after the primary insurance paid their part?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] uh
[CUSTOMER][NEUTRAL] OK. The charge, it's $87.71.
[AGENT][NEUTRAL] Thank you and can you please give me the name of your facility you're calling from?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yes, it's Global Pathology Laboratory Service.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, I'm gonna put you on a brief hold. Alcona while I look up this name I'll be right back.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEGATIVE] Oh, you are on hold.
[AGENT][NEUTRAL] Oh shoot.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Thank you for holding for me. I have the claim for you. The claim number is 356-6502.
[AGENT][NEUTRAL] And the claim was denied because covered when performed in a doctor's office or clinic for the patient's policy.
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Hello.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] You mean to say that the services are not covered by this policy, am I correct?
[AGENT][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Not when performed in a doctor's office or clinic.
[CUSTOMER][NEUTRAL] OK. You mean to say like the services are not covered by this policy, am I correct?
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] It's non-covered when performed in a doctor's office or clinic.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Non-covered?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Non-covered when performed in a doctor's office or clinic.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Can you spell non-covered afterward what you're saying? I'm not able to.
[CUSTOMER][NEUTRAL] Identify.
[CUSTOMER][NEUTRAL] Or.
[AGENT][NEUTRAL] A doctor's office.
[AGENT][NEGATIVE] Non-covered when performed.
[AGENT][NEUTRAL] In a doctor's office or clinic.
[CUSTOMER][NEUTRAL] a lot of
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] Doctor's office.
[CUSTOMER][NEUTRAL] OK. Non-covered through doctor's office or clinic. Am I correct?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Just a moment.
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] Just a moment.
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] OK. Um,
[CUSTOMER][NEUTRAL] What type of services can you help me with that?
[AGENT][NEUTRAL] What is what ma'am, please?
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Can you repeat?
[CUSTOMER][NEUTRAL] You're saying like uncovered, uncovered services, uncovered services through the doctor's office or clinic. Am I correct?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Uh, then what type of services I'm asking, means what type of services are not covered through doctor's office or clinic?
[AGENT][NEUTRAL] It doesn't cover office visits.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, office visits, OK.
[CUSTOMER][NEUTRAL] OK, thank you. Can you spell out your name for me?
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] Yes, it's [PII]
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII] OK. Can you give me the call reference number?
[AGENT][NEUTRAL] Yes, ma'am. You can use my name and today's date.
[CUSTOMER][POSITIVE] OK, thank you. Thank you for your assistance. Have a great day. Bye-bye.
[AGENT][POSITIVE] You have a wonderful day too. Is there anything else I can help you with before we go?
[CUSTOMER][NEUTRAL] No. Thank you.
[AGENT][POSITIVE] All right, you have a wonderful day. Thanks for calling APL. You're welcome. Bye bye.