AccountId: 011433970860
ContactId: d3ea481e-0592-4f83-807c-c7f5ebd531bf
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 365559 ms
Total Talk Time (AGENT): 93377 ms
Total Talk Time (CUSTOMER): 154210 ms
Interruptions: 2
Overall Sentiment: AGENT=0.2, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/04/d3ea481e-0592-4f83-807c-c7f5ebd531bf_20250204T17:39_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi [PII]. This side is [PII]. I'm calling from provider's office for the claim status.
[AGENT][NEUTRAL] OK. May I ask who's calling?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And how did you pronounce that?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Contage. And do you have a phone number I can get in case we get disconnected I can call you back?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Yes, the phone number is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Do you have the policy number?
[CUSTOMER][NEUTRAL] Yes, the policy number is 024.
[CUSTOMER][NEUTRAL] 84379.
[AGENT][NEUTRAL] Thank you. Hold on one moment, please.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] What's the patient's name?
[CUSTOMER][NEUTRAL] Patient's name is [PII].
[AGENT][NEUTRAL] Date of birth?
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][NEUTRAL] Thank you, Gunchi. And you are needing claim status?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, I can help you with that. Is this for dental?
[CUSTOMER][NEUTRAL] No, it's for medical.
[AGENT][NEUTRAL] OK, this is their dental policy number. Hold on one moment.
[CUSTOMER][NEUTRAL] So
[AGENT][NEUTRAL] And what date of service?
[CUSTOMER][NEUTRAL] Data services [PII].
[AGENT][NEUTRAL] Hold on one moment.
[AGENT][NEUTRAL] And what is one of the procedure codes on that claim?
[CUSTOMER][NEUTRAL] Procedure code actually I don't have the procedure codes on that.
[CUSTOMER][NEGATIVE] I I'm unable to see the EOB of that claim to.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Well
[AGENT][NEUTRAL] You know, the total charge or anything?
[CUSTOMER][NEUTRAL] Yes, the total charge amount is $1,893.69.
[AGENT][NEUTRAL] Hold on one moment, I'll see if I can find it, OK?
[CUSTOMER][NEUTRAL] OK, sure.
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] Well.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] That's
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] You good.
[AGENT][NEUTRAL] What's the name of the facility?
[CUSTOMER][NEUTRAL] Hillcrest Hospital, Claremore.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I
[AGENT][NEGATIVE] OK, we did get that claim in, it was denied.
[CUSTOMER][NEUTRAL] Yes
[AGENT][NEUTRAL] This test is not a covered diagnostic test under this policy. The only tests that we cover are MRI, CAT scan, thyroid uptake test, CT scan, PET scan.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] That particular diagnostic test is not covered.
[CUSTOMER][NEUTRAL] So not cover that? Diagnostic test not covered.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK. So it's not covered under patient plan, right?
[AGENT][NEUTRAL] That particular test is.
[AGENT][POSITIVE] Correct. Mhm.
[CUSTOMER][NEUTRAL] OK, so can you provide me the details of the claim like claim number under which the claim was processed?
[AGENT][NEUTRAL] Um, 351.
[AGENT][NEUTRAL] 4176.
[CUSTOMER][NEUTRAL] 35.
[CUSTOMER][NEUTRAL] 1763514176 is the claim number, right?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. And [PII], can you fax me the UB of this claim? I'll provide you the fax number.
[AGENT][NEUTRAL] What's the fax number?
[CUSTOMER][NEUTRAL] Yes, the fax number is 513.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, I'll fax it to you.
[CUSTOMER][NEUTRAL] OK, and I need the reference number of this call.
[AGENT][NEUTRAL] We do not have reference numbers. You can use my name in today's date.
[CUSTOMER][POSITIVE] OK, so thank you, [PII]. Have a nice day. Bye-bye.
[AGENT][POSITIVE] Thank you, [PII], for calling APL. You have a good day as well. Bye-bye.