AccountId: 011433970860
ContactId: c6b9f44b-4b37-4715-b603-41844c4222fc
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 177050 ms
Total Talk Time (AGENT): 63866 ms
Total Talk Time (CUSTOMER): 68756 ms
Interruptions: 0
Overall Sentiment: AGENT=1.8, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/03/c6b9f44b-4b37-4715-b603-41844c4222fc_20250103T20:06_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII], and I'm calling for provider to check on additional information about the claim that has been denied. Please note this call will be monitored and recorded for quality and training purposes. How's your day going?
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] OK. I'm doing well, [PII] how are you?
[CUSTOMER][POSITIVE] I'm doing great thank you for era.
[AGENT][POSITIVE] Yeah, of course, and then I can definitely check on that claim for you. Um, [PII], can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yes, it is [PII]. It's a direct line with no extension.
[AGENT][NEUTRAL] OK, thank you, and do you have the policy number?
[CUSTOMER][NEUTRAL] Yes, the policy number is 024350302.
[CUSTOMER][NEUTRAL] 390.
[AGENT][NEUTRAL] OK. And uh what was the name and date of birth for the insured?
[CUSTOMER][NEUTRAL] The name of the patient is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you for verifying that [PII] and do you have that claim number?
[CUSTOMER][NEUTRAL] Yes, it is 353-9016.
[AGENT][NEUTRAL] OK thank you one moment.
[AGENT][NEUTRAL] For a Virginia Urology Center.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] So for the procedure code 99214, uh, we were unable to pay that benefit as office visits are not covered under this policy.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. So office visits are not covered as for the patient's plan, correct?
[AGENT][POSITIVE] That's correct, yes.
[CUSTOMER][NEUTRAL] And may I know the patient's plan name?
[AGENT][NEUTRAL] Yes, it's a secondary medical policy.
[CUSTOMER][NEUTRAL] Secondary medical policy, correct?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] And just to verify on my end, the date is [PII]. Is that correct?
[AGENT][POSITIVE] What was that? I'm so sorry.
[CUSTOMER][NEUTRAL] The date on my end is [PII].
[AGENT][NEUTRAL] Uh, let me verify that.
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][POSITIVE] Thank you so much. And could you also please spell your name just for my documentation purpose?
[AGENT][NEUTRAL] Sure, it's [PII]
[CUSTOMER][POSITIVE] Thank you so much. And can I get the call reference number for this claim, [PII]?
[AGENT][NEUTRAL] Yeah, reference number would just be my first name, last initial, and today's date so my last initial is A.
[CUSTOMER][NEUTRAL] Um
[AGENT][NEUTRAL] And was there anything else I could help you with [PII]?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Oh, that's it for today. OK. Thank you so much for assisting me today. You have a great day ahead.
[AGENT][NEUTRAL] OK. Yeah.
[AGENT][POSITIVE] Thanks for calling APL you too bye bye.