AccountId: 011433970860
ContactId: bb127e4c-886a-4bc4-be89-d182e7840628
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 288279 ms
Total Talk Time (AGENT): 53015 ms
Total Talk Time (CUSTOMER): 133273 ms
Interruptions: 2
Overall Sentiment: AGENT=0.2, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/09/bb127e4c-886a-4bc4-be89-d182e7840628_20250609T19:20_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII] calling from provider's office. Check the client status.
[AGENT][NEUTRAL] OK, [PII], I can help you with the claim status. Do you have the policy number?
[CUSTOMER][NEUTRAL] Um, which is 024.
[CUSTOMER][NEUTRAL] 497554.
[AGENT][NEUTRAL] OK, thank you. And do you have a good callback number?
[CUSTOMER][NEUTRAL] Uh, which is [PII] direct line extension.
[AGENT][NEUTRAL] Thank you. And patient name and date of birth?
[CUSTOMER][NEUTRAL] Patients first name is [PII], sorry, uh [PII], last name is [PII], and his date of birth is [PII].
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And date of service and bill charges?
[CUSTOMER][NEUTRAL] Data services uh [PII].
[CUSTOMER][NEUTRAL] And total charge amount is $356 even 356.
[CUSTOMER][NEUTRAL] It was like.
[AGENT][NEUTRAL] It looks like the claim was received by [PII].
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] 05 195.
[CUSTOMER][NEUTRAL] Have.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] Office visits are not covered under the policy.
[CUSTOMER][POSITIVE] It's right.
[CUSTOMER][NEUTRAL] Uh, the payment is denied as a non-covered, right?
[AGENT][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] Uh, may I know the reason why it is non-covered?
[AGENT][NEUTRAL] Office visits are not covered under the policy.
[CUSTOMER][NEUTRAL] Uh, you guys post this claim as a secondary, right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, so we need to build the patient for $60.
[AGENT][NEUTRAL] Uh, we're a secondary policy, so we can't instruct on patient responsibility.
[CUSTOMER][NEUTRAL] OK. Um.
[CUSTOMER][NEUTRAL] In it in this COB, uh, whether it was indicated as a patient responsibility or provider right of.
[AGENT][NEUTRAL] It won't indicate either, cause it's secondary.
[AGENT][NEUTRAL] So we just, we simply process the claim and uh apply it to the policy provisions so we don't determine patient responsibility.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] OK, um, in this case, can you please fax a copy of your bill that you have?
[AGENT][NEUTRAL] The fax number?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, is there anything else I can help with today?
[CUSTOMER][NEUTRAL] Um, yes, ma'am, I have, uh, another patient, uh, sorry, another data service for the same member.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Are you ready for the date of service?
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] OK, ma'am. Thank you. The of service I have which is
[CUSTOMER][NEUTRAL] Oh, it's one just one second.
[CUSTOMER][NEUTRAL] $50.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I mean I know that right.
[CUSTOMER][NEUTRAL] Give me 1 2nd.
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] 355.
[CUSTOMER][NEUTRAL] Um for the.
[CUSTOMER][NEUTRAL] 270
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] Did you say there was another day of service?
[CUSTOMER][NEUTRAL] Yes ma'am, but that was already booked. OK, no issues. And uh may I get the call reference number?
[AGENT][NEUTRAL] Uh, it's my name is [PII], and today's date.
[CUSTOMER][POSITIVE] OK thank you bye.
[AGENT][POSITIVE] Thanks for calling APL. Bye-bye.