AccountId: 011433970860
ContactId: c4741293-5d05-48ca-a73a-1fa45f605582
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 278089 ms
Total Talk Time (AGENT): 51093 ms
Total Talk Time (CUSTOMER): 132891 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/11/c4741293-5d05-48ca-a73a-1fa45f605582_20250611T15:40_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII] calling from [PII]'s office checking on a time status.
[AGENT][NEUTRAL] OK, [PII], I can help you with claim status. Do you have a good callback number?
[CUSTOMER][NEUTRAL] Yeah, sure. Just give me a moment. Let me give you the callback number. It would be.
[CUSTOMER][NEUTRAL] [PII] with no extension.
[AGENT][NEUTRAL] OK. Do you have the policy number for the patient?
[CUSTOMER][NEUTRAL] Yeah, sure. Just one moment. Let me pull it up.
[CUSTOMER][NEUTRAL] Uh, it is 02538449 ML 8.
[AGENT][NEUTRAL] And patient name and date of birth?
[CUSTOMER][NEUTRAL] The patient name is [PII].
[CUSTOMER][NEUTRAL] [PII] and date of birth is on [PII].
[AGENT][NEUTRAL] OK, and then you said claim status, is that right?
[CUSTOMER][NEUTRAL] Yes
[AGENT][NEUTRAL] The date of service and bill charges?
[CUSTOMER][NEUTRAL] Is the date of service on uh [PII] and the bill amount is $155 even.
[AGENT][NEUTRAL] OK, looks like we processed the claim on or received 11-19 2024. Proceed 1121, 2024.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Office visits are not covered in.
[CUSTOMER][NEUTRAL] [PII], OK.
[AGENT][NEUTRAL] And office visits are not covered under the policy.
[CUSTOMER][NEUTRAL] Hm
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Covered. Fine.
[CUSTOMER][NEUTRAL] Uh, sure, go ahead.
[CUSTOMER][NEGATIVE] Not covered.
[CUSTOMER][NEUTRAL] I'm OK. I think I.
[CUSTOMER][NEUTRAL] And checking by your clearing out this claim has been rejected, right?
[AGENT][NEUTRAL] Uh, yeah, we were denied the claim, yes.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, uh, so, like, uh, uh, denied as a non-covered services.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] OK, thank you so much for that. Uh, OK, now for which CBD?
[AGENT][NEUTRAL] Yeah, it's just it's not a covered service office visits are not covered.
[CUSTOMER][NEUTRAL] OK, fine. One moment. Just give me one moment.
[CUSTOMER][NEGATIVE] I sad.
[CUSTOMER][POSITIVE] OK, thank you so much for that. And uh can I uh get the claim number for this?
[AGENT][NEUTRAL] 3533152.
[CUSTOMER][NEUTRAL] Um, 353152, it is 3533152, right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] OK, thank you so much for that. Uh, is there no other details or no paid claim rate for this one, this patient?
[AGENT][NEUTRAL] Uh, I'm sorry?
[CUSTOMER][NEUTRAL] Uh, there's no payment and any other denials for this claim, right?
[AGENT][NEGATIVE] We received the claim 2 times after this, and we denied it as a duplicate.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So, uh, so what is the original claim which is denied for non-covered? So original claim is a non-covered is denied as non-covered.
[AGENT][POSITIVE] Correct, the one that I gave you, yes.
[CUSTOMER][POSITIVE] OK, fine. Thank you so much for that. Uh just give me one moment, let me update here.
[CUSTOMER][NEUTRAL] Got it.
[CUSTOMER][POSITIVE] Thank you so much for that. And finally, can I get the call reference number, [PII]?
[AGENT][NEUTRAL] That's my name is [PII] and today's date.
[CUSTOMER][POSITIVE] OK. [PII], thank you so much for your assistance today and have a great day and thank you again and take care.
[AGENT][POSITIVE] Thank you for calling APL. You too. Bye bye.