AccountId: 011433970860
ContactId: caf5efaa-eba8-43ad-9a11-c80d94ae4dc2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 349899 ms
Total Talk Time (AGENT): 76776 ms
Total Talk Time (CUSTOMER): 164986 ms
Interruptions: 3
Overall Sentiment: AGENT=0.4, CUSTOMER=-0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/08/caf5efaa-eba8-43ad-9a11-c80d94ae4dc2_20250108T18:03_UTC.wav
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[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, I'm [PII] calling from provider's office, and I want to know about a claim status.
[AGENT][NEUTRAL] OK, I can help you with claim status. What was your name again, please?
[CUSTOMER][NEUTRAL] uh.
[CUSTOMER][NEUTRAL] It's uh it's [PII].
[AGENT][NEUTRAL] OK, the [PII].
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK thank you and then um what is your call back number just in case our call is disconnected?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Thank you. And then what is the patient's name for you?
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] Pediatrics
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, and what is the patient's name?
[CUSTOMER][NEUTRAL] Patient's name is [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII], I think. [PII].
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] OK, what is [PII]'s uh date of birth?
[CUSTOMER][NEGATIVE] I'm sorry, ma'am, your voice is breaking.
[AGENT][NEUTRAL] What is [PII]'s date of birth?
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] Thank you and then what is the date of service?
[CUSTOMER][NEUTRAL] Date of service is [PII].
[CUSTOMER][NEUTRAL] claims claims that uh.
[AGENT][NEUTRAL] And what is the charge amount?
[CUSTOMER][NEUTRAL] Total charges are $245.28.
[CUSTOMER][NEUTRAL] You can
[AGENT][NEUTRAL] OK, let me look at this policy real quick.
[CUSTOMER][NEUTRAL] You can go patient number to.
[CUSTOMER][NEUTRAL] And counter number for same patient.
[CUSTOMER][NEUTRAL] payment.
[AGENT][NEUTRAL] OK, what is the patient's policy number?
[CUSTOMER][NEUTRAL] Policy number is 1458575ML8.
[CUSTOMER][NEUTRAL] O
[AGENT][NEUTRAL] Thank you and then what is the charge amount after the primary insurance paid their part?
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] I think.
[CUSTOMER][NEUTRAL] OK. So the balance amount is $75.
[AGENT][NEUTRAL] OK, Boy, I'm gonna put you on a brief hold while I look this claim up for you and I will be right back.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK, ma'am. OK.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][POSITIVE] Thank
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Or.
[AGENT][NEUTRAL] Hi Beauty, this is [PII] back with you again. So I did find the claim. The claim number is 352.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] 4101.
[CUSTOMER][NEUTRAL] thought about it
[CUSTOMER][NEUTRAL] Remaining balance.
[AGENT][NEUTRAL] And the claim was denied, it's not a covered loss under the plan.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] It's gonna be yeah
[CUSTOMER][NEUTRAL] Uh, CPG not covered under the plan.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Uh, is it not, uh, cover under patient's plan, right?
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK, ma'am. Is there any other active insurance of for the same date of service?
[AGENT][NEUTRAL] No, ma'am.
[CUSTOMER][NEUTRAL] Um, oh, OK.
[CUSTOMER][NEUTRAL] Um, can I get the call reference number?
[AGENT][NEUTRAL] Yes ma'am, um, you can use my name as [PII] and today's date.
[CUSTOMER][NEUTRAL] OK, OK. Thank you. Bye-bye.
[AGENT][POSITIVE] Bye bye. You take care. Thanks for calling APL.
[CUSTOMER][POSITIVE] You're welcome. Bye.