AccountId: 011433970860
ContactId: cf55315d-8ba6-4952-967c-e945ebb7c6c1
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 275859 ms
Total Talk Time (AGENT): 67230 ms
Total Talk Time (CUSTOMER): 80311 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/23/cf55315d-8ba6-4952-967c-e945ebb7c6c1_20250523T20:23_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh hello, sir. My name is [PII]. I'm calling from Southern Plains Medical Center to check claim status.
[AGENT][NEUTRAL] OK. I to check on a claim. What is the policy number?
[CUSTOMER][NEUTRAL] Uh yeah. Policy number is 02545935.
[AGENT][NEUTRAL] All right, thank you. One moment.
[AGENT][NEUTRAL] May I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Ma'am my name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Thank you. And then what is the date of service?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the bill amount.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] $105 even.
[AGENT][NEUTRAL] Thank you. So the claim was received on [PII]. Claim was denied on [PII]. Office visits are not covered under the member's policy.
[CUSTOMER][NEUTRAL] Oh, office visit is not covered under the member policy.
[AGENT][POSITIVE] Mhm. Correct.
[CUSTOMER][NEUTRAL] I think this is a co-pay, OK, let me see.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] But insurance already paid for the office visit.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And even on uh
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Hello.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] What was the what was, what was the question?
[CUSTOMER][NEUTRAL] Yes, so.
[CUSTOMER][NEUTRAL] I wanted to say that this ah
[CUSTOMER][NEUTRAL] Office visit is already paid by the insurance.
[CUSTOMER][NEUTRAL] You can check date of service [PII].
[AGENT][NEUTRAL] We don't have a claim on file for [PII] for [PII]. We're the secondary insurance.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Uh, let me check.
[CUSTOMER][NEUTRAL] Yeah, why is mentioned as this.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. So what, what I can do on this like uh mm it's not for the member policy. So can I bill that to the patient?
[AGENT][NEUTRAL] We're not able to advise on patient responsibility, that would be up to the facility or the provider.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. Can I have a reference number, please?
[AGENT][NEUTRAL] Call reference is my name with today's date. My name again is [PII], that's [PII] Last initial is [PII], and then today's date.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Sir, can I have claim number, please?
[AGENT][NEUTRAL] 35897999.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you, [PII].
[AGENT][POSITIVE] You're welcome. Have a good day.