AccountId: 011433970860
ContactId: aa6ddf11-a2f1-4bfc-b877-9d68d1a1a13b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 352739 ms
Total Talk Time (AGENT): 123344 ms
Total Talk Time (CUSTOMER): 76694 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/16/aa6ddf11-a2f1-4bfc-b877-9d68d1a1a13b_20250116T15:21_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] Hi [PII], my name is [PII] calling from providers billing office checking for a claim status.
[AGENT][POSITIVE] Well [PII], it would be a pleasure to assist you with that claim status. What is the callback number in case we get disconnected please?
[CUSTOMER][NEUTRAL] Yes, it's [PII]. It's a direct line.
[AGENT][NEUTRAL] Thank you, [PII]. And what is the policy number for the patient?
[CUSTOMER][NEUTRAL] Yes, the member ID I have here.
[CUSTOMER][NEUTRAL] 023893887
[AGENT][NEUTRAL] And the patient's name and date of birth, please, sir?
[CUSTOMER][NEUTRAL] Yeah. It's for [PII].
[CUSTOMER][NEUTRAL] Date of birth, [PII].
[AGENT][POSITIVE] Alright thank you and it would be a pleasure to assist you with that claim status for [PII]. Do you have a claim number or date of service?
[CUSTOMER][NEUTRAL] Mm sorry, I don't have a claim number. Can I help you with the date of service, of services number 2, 2024 bill for $106 and $106.
[AGENT][NEUTRAL] Yes, sir.
[AGENT][NEUTRAL] All right, thank you and what is the facility name please, [PII]?
[CUSTOMER][NEUTRAL] Medical University Hospital Authority.
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] I'm checking on that claim for you, bear with me one moment.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] [PII], I'm showing that we did receive that claim on [PII].
[AGENT][NEUTRAL] It was processed on [PII].
[AGENT][NEUTRAL] And this policy, the claim was denied.
[AGENT][NEUTRAL] As not a covered loss under the plan, therefore, no benefit is payable.
[CUSTOMER][NEUTRAL] Mhm. Not covered per patient benefit plan.
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] Mhm. Could you help me with the plan type and the service render?
[AGENT][NEUTRAL] The plan, the plan type is a Medlink gap.
[CUSTOMER][NEGATIVE] Which was not covered.
[AGENT][NEUTRAL] And if you'll bear with me just one second, let me check a little further on this for you.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] Bear with me just one moment.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] I apologize, it's just taking my system a moment.
[CUSTOMER][POSITIVE] Take your time, sir. No issues.
[AGENT][NEUTRAL] So is this for an office visit, a clinic visit?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEGATIVE] And it is not covered under the plan.
[CUSTOMER][NEUTRAL] Office visit or?
[AGENT][NEUTRAL] So for the
[AGENT][NEGATIVE] Not covered under the policy.
[AGENT][NEUTRAL] So it's not covered by the patient's plan.
[CUSTOMER][NEUTRAL] Sure and um.
[CUSTOMER][NEUTRAL] On.
[CUSTOMER][NEUTRAL] And is that possible for you to fax me an EOB for this sir?
[AGENT][NEUTRAL] EOBs are obtainable from our portal at [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yes, sir.
[AGENT][NEUTRAL] It's a simple self-registration using the tax ID number and the patient's account number inbox 3A on the UBO4.
[CUSTOMER][NEUTRAL] Sure, we get that. Do you help me with the claim number?
[AGENT][NEUTRAL] Claim number is 353.
[AGENT][NEUTRAL] 3788.
[CUSTOMER][NEUTRAL] Sure. May I have a call reference?
[AGENT][NEUTRAL] It's gonna be my name in today's date. I spell my name [PII].
[CUSTOMER][POSITIVE] Thank you, [PII], and thanks for assisting. Uh, good take care also.
[AGENT][NEGATIVE] I no.
[AGENT][POSITIVE] Oh, thank you for calling APL [PII]. I hope you have a wonderful day and thank you for calling APL.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Bye-bye.
[CUSTOMER][POSITIVE] Thank you. Take care. Bye.