AccountId: 011433970860
ContactId: c8ba45c7-90ea-42d8-ab40-d165c70fec17
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 194770 ms
Total Talk Time (AGENT): 62332 ms
Total Talk Time (CUSTOMER): 76124 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/28/c8ba45c7-90ea-42d8-ab40-d165c70fec17_20250228T13:42_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Oh yeah, hi, good, good morning, [PII]. My name is [PII] and I'm calling from provider's office to check on claim status.
[AGENT][NEUTRAL] OK, and spell your name for me please.
[CUSTOMER][NEUTRAL] It's [PII] spelled as [PII]
[AGENT][NEUTRAL] OK, and you said you're checking claim status, [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, can I get a policy number and a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yeah, sure. The policy number is 02331575 M as in Mike L as in Lima 8.
[CUSTOMER][NEUTRAL] And my contact number is [PII].
[CUSTOMER][NEUTRAL] [PII] and it is a direct line.
[AGENT][POSITIVE] Thank you one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And what is the patient's, what is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Uh, the patient's name is [PII], and the date of birth is [PII].
[AGENT][NEUTRAL] Thank you for that information if you provide the date of service and the total charge?
[CUSTOMER][NEUTRAL] Sure. The date of service is [PII] and the total charge amount is
[CUSTOMER][NEUTRAL] $194.44.
[AGENT][NEUTRAL] Thank you. I'm showing that this claim was received on [PII], processed [PII]. Um, the claim was not payable as office visits are not covered by the patient's policy.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I'm showing the claim processed under claim number 355.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] 4486.
[AGENT][NEUTRAL] And [PII], you can also check claim status online at [PII].
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] And did you have any other questions?
[CUSTOMER][NEUTRAL] Mm, yes. I, I have a question about this claim. Uh, so may I know whether, uh, what is the name of the patient's plan or policy?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] This is a supplemental, this is a Metlink policy.
[CUSTOMER][NEUTRAL] Maybe
[AGENT][NEUTRAL] So it's secondary to the major medical plan?
[CUSTOMER][NEUTRAL] OK, fine. So could you check whether the provider is in network or out of network?
[AGENT][NEGATIVE] There is no network.
[CUSTOMER][POSITIVE] OK, fine. Thank you so much. Uh, [PII], can you also provide me the call reference for this call?
[AGENT][NEUTRAL] My name and today's date.
[CUSTOMER][POSITIVE] Thank you so much, [PII]. Thank you for your assistance and have a great day and have a great weekend. Bye for now.
[AGENT][POSITIVE] You're welcome.
[AGENT][POSITIVE] You're welcome, [PII]. Thank you for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] Yeah.