AccountId: 011433970860
ContactId: d38e6a6c-c92b-4616-9557-2040e583b345
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 184020 ms
Total Talk Time (AGENT): 61454 ms
Total Talk Time (CUSTOMER): 94311 ms
Interruptions: 0
Overall Sentiment: AGENT=2.2, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/27/d38e6a6c-c92b-4616-9557-2040e583b345_20250127T22:33_UTC.wav
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[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, did you say [PII] is your name?
[AGENT][NEUTRAL] Yeah, my name is [PII], uh-huh.
[CUSTOMER][NEUTRAL] OK, thank you, [PII]. My name is [PII]. I'm with Kingman Regional Medical Center and I'm calling about a claim.
[AGENT][POSITIVE] OK, I'm happy to check on.
[CUSTOMER][NEUTRAL] You go ahead and ask me what you need to ask me. Thank you.
[AGENT][POSITIVE] Yeah, absolutely, yeah, no worries. What's the policy, [PII]?
[CUSTOMER][NEUTRAL] It is let me get back to that.
[CUSTOMER][NEUTRAL] Um, 02483289.
[AGENT][POSITIVE] All right, thank you for that.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] And if I could get patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yes, um, uh, I, I, his, his name is either [PII] or [PII]. Last name is [PII], and his date of birth is [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Alright, thank you so much and then what's the date of service [PII]?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] In the build amount.
[CUSTOMER][NEUTRAL] $328.
[AGENT][NEUTRAL] Alright, let's see yeah.
[AGENT][NEUTRAL] Alright, so it looks like we did receive a claim for this on [PII]. Uh, the claim was denied office visits are not covered under the member's policy.
[CUSTOMER][NEUTRAL] OK, office visits not covered. OK, so I'll go ahead and put this on the patient then. So office visits are not covered by the way, I couldn't tell by looking at the card. What plan do they have? What supplemental plan is this?
[AGENT][NEUTRAL] So
[AGENT][NEUTRAL] This is a secondary med link plan.
[CUSTOMER][NEUTRAL] Oh, secondary med link, OK, so it's not like a, a Medicare, uh, supplemental.
[AGENT][NEUTRAL] Mm, mm.
[CUSTOMER][NEUTRAL] OK, OK, so it's a secondary me and um the and you do not pay for office visits.
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] OK, oh thank you so much, [PII]. Uh thank you for, uh, looking into that for me. Um, you, I'm so what you said [PII] was your name, right?
[AGENT][NEUTRAL] No, my name is [PII]. That's OK.
[CUSTOMER][NEUTRAL] [PII], oh sorry, [PII]. OK, [PII], I said [PII]?
[AGENT][POSITIVE] Yeah, exactly.
[CUSTOMER][NEUTRAL] Or no [PII] OK and do you have a reference number for this call?
[AGENT][NEUTRAL] Absolutely [PII] call reference is going to be my name with my last initial and then today's date. The last initial to my name is [PII].
[CUSTOMER][NEUTRAL] And then uh [PII].
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][POSITIVE] OK, sir, thank you so much, honey. You have a wonderful rest of your day.
[AGENT][POSITIVE] You too, take care.
[CUSTOMER][POSITIVE] Thank you bye bye.