AccountId: 011433970860
ContactId: b79e3fe3-af13-42ce-a592-827a63ff54fc
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 221720 ms
Total Talk Time (AGENT): 99944 ms
Total Talk Time (CUSTOMER): 47118 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/28/b79e3fe3-af13-42ce-a592-827a63ff54fc_20250228T18:20_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yeah. Yeah, hi, this is [PII] calling from the provider's office. Checking on a claim status.
[AGENT][NEUTRAL] OK [PII], you have one claim that you're wanting to check claim status on, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Yes, I can help you with that. And what is your callback number, please?
[CUSTOMER][NEUTRAL] Yeah, it's uh [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you and the member's policy number please, [PII].
[CUSTOMER][NEUTRAL] Yeah it's uh 0229581.
[CUSTOMER][NEUTRAL] Number 3, M as in Mary, L as in Lima, and number 8.
[AGENT][NEUTRAL] OK, thank you. So give me a couple of moments please to get the member's information pulled up.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] And [PII], any information that I do provide for you today would be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth?
[CUSTOMER][NEUTRAL] Yeah, the patient's first name is [PII] and the last name is uh [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] Thank you and what is the date of service and total bill amount for her, please?
[CUSTOMER][NEUTRAL] Yeah, that service is on [PII].
[CUSTOMER][NEUTRAL] And the total charge amount is $542 even.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 542. Is that correct?
[CUSTOMER][NEUTRAL] Yes, yeah.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, and here we did receive this claim.
[AGENT][NEUTRAL] This claim was received on [PII].
[AGENT][NEGATIVE] It was processed and denied on [PII].
[AGENT][NEUTRAL] The claim number is 354.
[AGENT][NEUTRAL] 984 3.
[AGENT][NEUTRAL] And the reason for the denial state's office visits are not covered by the above numbered policy.
[AGENT][NEUTRAL] The members supplemental plan, [PII] does not cover office visits.
[AGENT][NEUTRAL] [PII], are you still there?
[CUSTOMER][NEUTRAL] Yeah, can I get a call number for this one?
[AGENT][NEUTRAL] Yes, actually I wanna give you one additional piece of information. If you need a copy of this explanation of benefits now that you have the claim number, you can print it from our portal and our portal website is secured. [PII] and you would use my name along with today's date as your call reference number.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Yeah. Thanks for that and I got you with the porter.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] OK, well then, if that is all I can help you with, thank you again for calling APO and I hope you have a nice weekend.
[CUSTOMER][POSITIVE] Yeah you too bye bye have a great weekend.
[AGENT][POSITIVE] Thank you. You too. Bye-bye.