AccountId: 011433970860
ContactId: d133e54c-0321-4b60-9b0c-902dfacc7811
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 407920 ms
Total Talk Time (AGENT): 123862 ms
Total Talk Time (CUSTOMER): 103890 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/03/d133e54c-0321-4b60-9b0c-902dfacc7811_20250603T13:31_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yeah, hello ma'am. My name is [PII]. I'm calling from provider's office to check on a claim status.
[AGENT][NEUTRAL] OK, I'm happy to check on a claim. Can I get the policy number?
[CUSTOMER][NEUTRAL] Yes, uh,
[CUSTOMER][NEUTRAL] So 02300724. M as in Mike, L as in Lima, number 8.
[AGENT][POSITIVE] Thank you. And do you have a good callback number?
[CUSTOMER][NEUTRAL] Yes, it's [PII]. Also I would like to inform you that this call is being recorded for quality and training purposes.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII]. Date of birth.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And then data service.
[CUSTOMER][NEUTRAL] [PII] total charge.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] $662 even.
[AGENT][NEUTRAL] Data service just to reconfirm [PII], yes?
[CUSTOMER][POSITIVE] Uh, I'm so sorry about that. It's, uh, not the [PII], it's uh [PII].
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] [PII] correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] Not showing any claims on file for that date of service.
[CUSTOMER][NEUTRAL] OK, no problem, ma'am. I do have uh just 3 more data service for the same patient if you could assist me.
[AGENT][NEUTRAL] OK. What's the next date?
[CUSTOMER][NEUTRAL] Uh, [PII] total charge to.
[CUSTOMER][NEUTRAL] $952 even.
[AGENT][NEUTRAL] And that was [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] No claims on file for that date of service.
[CUSTOMER][NEUTRAL] OK, [PII] total charge $1,984 even.
[AGENT][NEUTRAL] What was the charge on [PII], 1000?
[CUSTOMER][NEUTRAL] 984.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so it looks like we did receive a claim on [PII] for this state of service.
[AGENT][NEUTRAL] The claim was processed on [PII].
[AGENT][NEGATIVE] Was denied needing the explanation of benefits from the primary insurance.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, so, ma'am, can you tell me, uh, is, are the office visits covered in this patient's plan?
[AGENT][NEUTRAL] Let me double check and see if the office visit uh will be covered. One moment.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] OK, so it looks like the patient plan will cover um any treatment incurred in a physician's office. It does not cover the office visit fee.
[CUSTOMER][NEUTRAL] OK, can you provide me the claim number for this one?
[AGENT][NEUTRAL] 360-1852.
[CUSTOMER][NEUTRAL] Got you, yeah, just one last data service.
[AGENT][NEUTRAL] OK, what's the other day?
[CUSTOMER][NEUTRAL] [PII] total charge $1,471 even.
[AGENT][NEUTRAL] This claim is received on [PII].
[AGENT][NEUTRAL] Claim was processed and denied [PII] or [PII], excuse me, [PII]. We need the explanation of benefits from the primary insurance.
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] OK, and the claim number for this one.
[AGENT][NEUTRAL] 360-185-5.
[CUSTOMER][POSITIVE] Got you. Thank you so much, ma'am. Just the call reference.
[AGENT][NEUTRAL] Call references my name with today's date. My name again is [PII], that's [PII] Last initial is [PII], then today's date.
[CUSTOMER][POSITIVE] Got you. Thank you so much, ma'am. That's all. You have a great day ahead.
[AGENT][NEUTRAL] You too, [PII]. Bye bye.