AccountId: 011433970860
ContactId: b38d6897-2d20-4932-9a31-ff28344dda2c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 240080 ms
Total Talk Time (AGENT): 84893 ms
Total Talk Time (CUSTOMER): 81268 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/24/b38d6897-2d20-4932-9a31-ff28344dda2c_20250124T19:00_UTC.wav
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[AGENT][NEUTRAL] For calling APL, this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hello, this is [PII], and initial of my last name is [PII], and I've called you to check on a claim.
[AGENT][NEUTRAL] OK, I can help you spell your first name for me.
[CUSTOMER][NEUTRAL] Uh, it's [PII].
[AGENT][NEUTRAL] OK, and the policy number?
[CUSTOMER][NEUTRAL] It is 01731964 M as in Mary, L as in Lima, number 8.
[AGENT][NEUTRAL] OK, and what's a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] It's [PII] and the extension would be [PII].
[AGENT][POSITIVE] Thank you, one moment.
[CUSTOMER][NEUTRAL] And sorry, but what was your name again? Can you spell it out for me?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Uh, I didn't get that.
[AGENT][NEUTRAL] What's it?
[AGENT][NEUTRAL] What's the patient's name and date of birth?
[CUSTOMER][NEUTRAL] The
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] And date of birth is [PII].
[AGENT][NEUTRAL] OK. Uh my name is [PII]
[AGENT][NEUTRAL] As [PII] [PII].
[CUSTOMER][POSITIVE] All right, [PII]. Thank you so much.
[AGENT][NEUTRAL] In a mall. Can you, you're welcome. Can you provide the date of service and charge amount?
[CUSTOMER][NEUTRAL] Yes, it's [PII]. Charge amount would be $420 even.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And can you verify the procedure codes on the claim?
[CUSTOMER][NEUTRAL] Uh, yes, it is.
[CUSTOMER][NEUTRAL] 993-94961279255199173.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So the claim was received to [PII], processed [PII].
[AGENT][NEUTRAL] I'm showing that the office visit fee is not covered by the patient's policy and then treatment in the office is not covered by the patient's policy, so no payment was made on this claim. And let me know when you're ready for the claim number.
[CUSTOMER][POSITIVE] Yes, I'm ready.
[AGENT][NEUTRAL] It's 353-66.
[AGENT][NEUTRAL] 22
[AGENT][NEUTRAL] And you can also check your status on the online service center at [PII]. And any other questions I can assist with today?
[CUSTOMER][NEUTRAL] I know.
[CUSTOMER][NEUTRAL] Uh, yes, can you help me with the uh procedure code 96127 because it was a transfer claim from primary to secondary and the balance was left on the procedure code 96127. What about that procedure code it is paid or?
[AGENT][NEUTRAL] So that's
[AGENT][NEUTRAL] The office visit is not covered by the policy. The other codes are treatment codes which are not covered by the policy.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Not covered by the policy. Any, anything in detail about that?
[CUSTOMER][NEGATIVE] Not covered in all
[AGENT][NEUTRAL] They're not covered by the patient's policy.
[CUSTOMER][NEUTRAL] All right. One moment.
[CUSTOMER][POSITIVE] All right, thank you so much for that, [PII]. Help me with the call reference number for this.
[AGENT][POSITIVE] Mhm you'll use my name in today's date as your reference and any other questions at all I can assist with today?
[CUSTOMER][POSITIVE] No, thank you so much [PII]. Have a great day.
[AGENT][POSITIVE] You're welcome thanks for calling APL have a good day.
[CUSTOMER][NEUTRAL] All right.