AccountId: 011433970860
ContactId: bb006509-d8d8-4323-a9eb-cdcb329fe56f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 323959 ms
Total Talk Time (AGENT): 87992 ms
Total Talk Time (CUSTOMER): 100030 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/17/bb006509-d8d8-4323-a9eb-cdcb329fe56f_20250417T19:18_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yeah. Hi, [PII]. My name is [PII]. Uh, I'm calling from office to check on the claim status.
[AGENT][NEUTRAL] Of course, I can help you with claim status today. What did you say your name was?
[CUSTOMER][NEUTRAL] It's uh [PII]. That's [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And then do you have the policy number on you?
[CUSTOMER][NEUTRAL] Sure, uh, the policy number is uh.
[CUSTOMER][NEUTRAL] 02487948 M as in Mike. L as in Lima 8.
[AGENT][POSITIVE] Perfect, thank you.
[AGENT][NEUTRAL] And then what's a good callback number in case we get disconnected?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] OK. And the patient's first and last name and date of birth, please?
[CUSTOMER][NEUTRAL] Patient's name is [PII]. The date of birth is [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, and then do you have a data service and charge amount?
[CUSTOMER][NEUTRAL] It's for [PII]. The charge amount is for $324 324 dollars.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Sorry, just one moment.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, so it looks like the received date was [PII].
[AGENT][NEUTRAL] And the process date was [PII].
[AGENT][NEGATIVE] And this claim was denied.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] I am
[AGENT][NEUTRAL] See.
[AGENT][NEUTRAL] OK. So, this claim was denied because office visits are not covered by the policy.
[CUSTOMER][NEUTRAL] It is not covered by all right. So you have the claim for the pro 99213 only, right? for [PII].
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes, [PII], and the amount of $324. Mhm.
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] Uh, can you provide me like a claim number?
[AGENT][NEUTRAL] Yes, the claim number is 358.
[AGENT][NEUTRAL] 3999.
[CUSTOMER][NEUTRAL] Right, uh, you know, if I want the UOB, I can get the UB through portal or like, uh, do you have an option to fax the COB?
[AGENT][POSITIVE] Yes, I do. I can give you our fax number.
[CUSTOMER][NEUTRAL] Uh, yes, I mean, like it's, uh, you're asking my fax number, right?
[AGENT][NEUTRAL] No, would you like our fax number?
[CUSTOMER][NEUTRAL] Uh, no, it's fine. Can you able to fax me this copy of, you know, you know, it's fine, no issues. I'll check in the portal, uh, American Public Life portal. I think I have an access for that. I'll check with this. So I can get this through portal with the claim number, right?
[AGENT][NEUTRAL] Yes, sir, you can. Mhm.
[CUSTOMER][NEUTRAL] OK. I'll check with this and uh you know, can you help me with like a call reference number?
[AGENT][NEUTRAL] Yes, of course. It's my first name, which is [PII].
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] Last initial [PII]
[AGENT][NEUTRAL] And then today's date.
[CUSTOMER][POSITIVE] In [PII], right, you know, thanks for helping me with this information, [PII].
[AGENT][NEUTRAL] Of course, is there anything else I can help you with?
[CUSTOMER][NEUTRAL] Uh, no, this is the only claim I have for the day.
[AGENT][POSITIVE] OK, sounds good. Well, thank you for calling APL and I hope you have a good day.
[CUSTOMER][POSITIVE] You have a great day thank you bye now.
[AGENT][POSITIVE] Thank you, bye.