AccountId: 011433970860
ContactId: b307a0dd-8be1-46a9-9847-45d768ca7e6a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 299179 ms
Total Talk Time (AGENT): 96210 ms
Total Talk Time (CUSTOMER): 111634 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/12/b307a0dd-8be1-46a9-9847-45d768ca7e6a_20250512T16:59_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Yeah, hi, this is [PII]. My last name is [PII], and I'm calling for the provider to check additional information about the claim that has been denied. Please note this call will be monitored and recorded for quality and training purposes. How are you doing today?
[AGENT][NEUTRAL] I'm fine. I can verify claim status for you and I apologize, your name is again?
[CUSTOMER][NEGATIVE] Losing.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And Ms. [PII], what is the policy number, please?
[CUSTOMER][NEUTRAL] Um, sure, the policy number I have here is.
[CUSTOMER][NEUTRAL] 02519056.
[AGENT][NEUTRAL] OK, thank you. And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] Yes, that is [PII]. Is it right, right?
[AGENT][NEUTRAL] Thank you. And the patient's name, date of birth?
[CUSTOMER][NEUTRAL] Um, sure, the patient's first name is going to be [PII]. Last name is [PII], and date of birth is [PII].
[AGENT][NEUTRAL] Thank you and what was the date of service and amount of the charge?
[CUSTOMER][NEUTRAL] Sure, the data service I have here is.
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] You said [PII]?
[CUSTOMER][NEUTRAL] No, no. [PII] with the bill amount is $345 even.
[AGENT][NEUTRAL] OK, thank you one moment and while I'm looking up claim information just to let you know we do have an online service center where providers can check claim status as well as print out the EOB. That site is at secured. Am as in [PII], and you're calling from again?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Or what is the name of the provider's office?
[CUSTOMER][NEUTRAL] That is the Florida International University Board of Trustees.
[AGENT][POSITIVE] OK, thank you so much.
[AGENT][NEUTRAL] I'm showing the claim processed as office visits are not covered per the policy.
[CUSTOMER][NEUTRAL] OK. Just a moment.
[CUSTOMER][NEUTRAL] No offices that are not under your guidelines or patient's policy or provider's contract.
[AGENT][NEUTRAL] Per the patient's policy, office visits are not covered.
[CUSTOMER][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Just a moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Policy name?
[AGENT][NEUTRAL] Medlik, M E D L I N K.
[CUSTOMER][NEUTRAL] The one word, right?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] At link
[CUSTOMER][NEUTRAL] It's a two different one or it's one word M link?
[AGENT][NEUTRAL] It's just one word, [PII]
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] Thank you so much.
[CUSTOMER][NEUTRAL] And your name please?
[AGENT][NEUTRAL] Sure, it's [PII], last initial [PII].
[CUSTOMER][POSITIVE] Thank you. Just a moment, please.
[CUSTOMER][NEUTRAL] Just noted all that information.
[CUSTOMER][NEUTRAL] To be.
[CUSTOMER][NEUTRAL] A for.
[CUSTOMER][NEUTRAL] And the claim number ends with 35891999. Am I correct?
[AGENT][NEUTRAL] No, ma'am. Uh, that is the second time the claim was received. It processed as a duplicate. The initial claim number is 3559601.
[CUSTOMER][NEUTRAL] Thank you and that initial claim. Just a moment.
[CUSTOMER][NEUTRAL] 601.
[CUSTOMER][NEUTRAL] And that is processed on um.
[CUSTOMER][NEUTRAL] I have here the date is.
[CUSTOMER][NEUTRAL] Just a moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] [PII], right? Process done originally?
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Call reference number, please.
[AGENT][NEUTRAL] OK,
[AGENT][NEUTRAL] Uh, we don't give reference numbers. If you like, you may use my name in today's date, and is there anything else I can assist you with today?
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] That's all. Thank you so much for assistance. take care. Have a good day. Bye-bye. Take care.
[AGENT][POSITIVE] Alright you too thank you for calling APL.
[AGENT][NEUTRAL] Bye.