AccountId: 011433970860
ContactId: d44620f6-27a8-49dd-9a63-1afb323f050a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 470040 ms
Total Talk Time (AGENT): 136838 ms
Total Talk Time (CUSTOMER): 216499 ms
Interruptions: 4
Overall Sentiment: AGENT=0.3, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/23/d44620f6-27a8-49dd-9a63-1afb323f050a_20250523T18:53_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hello, this is [PII] calling on behalf of the provider.
[AGENT][POSITIVE] Hi [PII], what can we help you with today?
[CUSTOMER][NEUTRAL] Uh, I called regarding to check on the claim status.
[AGENT][NEUTRAL] OK, I could check on a claim for you. Uh, can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] Yeah, it is [PII].
[AGENT][NEUTRAL] Thank you. And then do you have the policy number?
[CUSTOMER][NEUTRAL] Yeah, one second. The policy number would be
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] 02
[CUSTOMER][NEUTRAL] 58.
[CUSTOMER][NEUTRAL] 4349.
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, what was the name and date of birth for this number?
[CUSTOMER][NEUTRAL] Name is [PII], and the last name it is [PII].
[CUSTOMER][NEUTRAL] And the date of birth would be uh [PII].
[AGENT][NEUTRAL] OK, thank you for verifying that and what was the date of service for this claim?
[CUSTOMER][NEUTRAL] Yeah, it would be [PII] and the amount of $542 even.
[AGENT][NEUTRAL] OK thank you one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so we did receive this claim, [PII], we were unable to pay a benefit as office visits are not covered under this policy.
[CUSTOMER][NEUTRAL] Sorry, sorry.
[AGENT][NEUTRAL] We did receive this claim, yes, we were unable to pay a benefit as office visits are not covered under this policy.
[CUSTOMER][NEUTRAL] Could you please repeat once again?
[CUSTOMER][NEUTRAL] That's are not covered. OK. May I know the received date?
[AGENT][NEUTRAL] This claim was received [PII], and it was processed on [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. And the claim number would be?
[AGENT][NEUTRAL] That is 3591348.
[CUSTOMER][NEUTRAL] OK. Patient is not having any other insurance.
[AGENT][NEUTRAL] Um, not through us.
[CUSTOMER][NEUTRAL] OK, so what about uh the, what about uh the offices with that is not covered, so we need to build the patient, the left out balance.
[AGENT][NEUTRAL] We don't say what is we do not say what is patient responsibility that would be up to the provider.
[CUSTOMER][NEUTRAL] OK. Just give me a moment.
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] And could you please spell your name for me?
[AGENT][NEUTRAL] It's [PII]. Was there anything else I can help you with [PII]?
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] Uh yes, I'm having 3 more creams for the same patient.
[AGENT][NEUTRAL] Is this for the same number?
[CUSTOMER][NEUTRAL] Yeah, same number.
[AGENT][NEUTRAL] OK, uh, what was that next date of service?
[CUSTOMER][NEUTRAL] Yeah, I'm getting open. The next date of service is [PII].
[CUSTOMER][NEUTRAL] It
[AGENT][NEUTRAL] OK, and then that bill amount, please?
[CUSTOMER][NEUTRAL] Uh, the amount is $237 even.
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, uh, so this one is the same, Peter, we were unable to pay a benefit as office visits are not covered.
[CUSTOMER][NEUTRAL] For
[CUSTOMER][NEUTRAL] OK. And the claim, uh, uh, receipt and the dinner date.
[AGENT][NEUTRAL] This claim was received [PII].
[AGENT][NEUTRAL] And it was processed on [PII].
[CUSTOMER][NEUTRAL] OK. Claim number.
[AGENT][NEUTRAL] 3601.
[AGENT][NEUTRAL] 407.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] And we'll go with one tomorrow and the date of service. One second, it's getting open.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mm, the date of service would be [PII], but the amount of, uh, I think it got finalized. Sorry, just give me a moment. Uh, I'm checking the status. Yeah, sorry for that.
[AGENT][NEUTRAL] That's OK. Sure.
[AGENT][NEUTRAL] That's OK.
[CUSTOMER][NEUTRAL] OK. It got finalized. Uh, we'll go with the other one.
[CUSTOMER][NEUTRAL] One minute.
[AGENT][NEUTRAL] You're fine.
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Yeah, the other claim, the date of service would be uh [PII].
[CUSTOMER][NEUTRAL] A bill amount of $4,288 even.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, was that the amount before or after a major medical paid?
[CUSTOMER][NEUTRAL] Uh, one second.
[CUSTOMER][NEUTRAL] Just a moment. I'll give the clarity on that.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] I want it showing 4288 only.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, was this is from the same.
[CUSTOMER][NEUTRAL] For the present, uh,
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Yeah, go ahead, go ahead. Go ahead, go ahead.
[AGENT][NEUTRAL] Um, I'm just going to, uh, sure, was this for, uh, was this with the same provider as the previous two claims Gastro Health?
[CUSTOMER][POSITIVE] Yes, yes. Yes, yes.
[AGENT][NEUTRAL] OK, so we have not received that claim.
[AGENT][NEUTRAL] I only have one claim on file for that date of service for a different amount and from a different provider.
[CUSTOMER][NEUTRAL] And.
[CUSTOMER][NEUTRAL] OK. Uh, one second. Uh.
[CUSTOMER][NEUTRAL] And the no provider name on the claim it's showing uh [PII].
[AGENT][NEUTRAL] No, it's a completely different provider and a different amount.
[CUSTOMER][NEUTRAL] It's
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So there's a no claim on file you're saying, am I right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] One second, I'll
[CUSTOMER][POSITIVE] I'm checking it when it got, it got better.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Yeah, it got built recently, uh, 5:22, so I think it will take time. Thank you. And uh yeah, call reference num[PII] would be.
[AGENT][NEUTRAL] Oh, it's right we probably haven't received it yet.
[AGENT][NEUTRAL] My first name, last initial, and today's date and uh so my name is spelled [PII] Last [PII]
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][POSITIVE] Thank you so much and have a great day. Bye-bye.
[AGENT][POSITIVE] Of course, yep, thanks for calling APL you too bye bye.
[CUSTOMER][NEUTRAL] Bye-bye.
[CUSTOMER][NEUTRAL] Mm