AccountId: 011433970860
ContactId: be0953a0-50bc-4c12-99f4-de6321207efa
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 303359 ms
Total Talk Time (AGENT): 72763 ms
Total Talk Time (CUSTOMER): 193891 ms
Interruptions: 7
Overall Sentiment: AGENT=0.5, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/24/be0953a0-50bc-4c12-99f4-de6321207efa_20250424T17:11_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey [PII], I've got a provider on the back line that wants to get the claim status on an insurance policy.
[AGENT][NEUTRAL] OK, I, I can help them with that. Do you have the um policy number for the patient?
[CUSTOMER][NEUTRAL] I do. It's 1896422 on a Glen Beaver and I did verify everything with the provider.
[AGENT][POSITIVE] OK, perfect. You have a callback number?
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] I do. The callback number is [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] And she stated her name was [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right. Here she goes. Thank you and have a good day.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII] calling from provider's office to check up on the claim status.
[AGENT][NEUTRAL] OK, do you have the date of service, build them out?
[CUSTOMER][NEUTRAL] I know what it.
[CUSTOMER][NEUTRAL] Date of service that is [PII] with a billed amount of $209 even.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah yeah
[CUSTOMER][NEUTRAL] I have.
[AGENT][NEUTRAL] It looks like that claim was received 3-13-2025. Process 317-25.
[CUSTOMER][NEUTRAL] We haven't.
[AGENT][NEUTRAL] Office visits are not covered under the policy.
[CUSTOMER][NEUTRAL] OK, is it is the patient's responsibility.
[AGENT][NEUTRAL] We're secondary policy, so we don't determine patient responsibility.
[CUSTOMER][NEUTRAL] what
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, it depends upon the provider.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] It just depends upon the provider to the patient.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] We, we don't give, we can't give authorization on how to bill a patient. This is a secondary policy.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, office visit is not covered under the patient's plan.
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] Good afternoon.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Can I have the next patient.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Can I have the next member.
[AGENT][NEUTRAL] You wanna check claim status on another member?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEUTRAL] That's uh.
[AGENT][NEUTRAL] What was your name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Do you spell it?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] That to me.
[AGENT][NEUTRAL] OK and the policy number for the next patient?
[CUSTOMER][NEUTRAL] Yes, it is 02458526.
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] Patient's name, it is [PII] and the date of birth it is [PII], sorry, date of birth it is [PII].
[CUSTOMER][NEUTRAL] Well.
[AGENT][NEUTRAL] And data service and bill charges?
[CUSTOMER][NEUTRAL] It is service that is [PII] with the bill amount of $354.29.
[CUSTOMER][NEUTRAL] Maybe
[CUSTOMER][NEUTRAL] that's it.
[AGENT][NEUTRAL] Uh, that was received 314-2025, process 3-18-2025.
[CUSTOMER][NEUTRAL] Yeah that might be like the the.
[AGENT][NEUTRAL] And let me see what the.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, office visits are not covered under the policy, and then the other charge was not covered under the policy as well.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, that it is the patient's responsibility then?
[AGENT][NEUTRAL] We don't determine patient responsibility.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] E
[CUSTOMER][NEUTRAL] You know it goes on
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, thank you. Could you spell out your name?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Yeah it is I have no idea.
[CUSTOMER][POSITIVE] Thank you. Can I call reference number? Thank you. Have a nice day.
[AGENT][NEUTRAL] My name plus today's date.
[AGENT][NEUTRAL] If you use what