AccountId: 011433970860
ContactId: d5a502a8-464a-4470-8270-9abc34254757
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 419140 ms
Total Talk Time (AGENT): 89506 ms
Total Talk Time (CUSTOMER): 77024 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/27/d5a502a8-464a-4470-8270-9abc34254757_20250527T18:54_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi, I'm [PII] calling from provider's office for checking on a claim.
[AGENT][NEUTRAL] OK, I can verify claim status set up for you and your name is again?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and [PII], what is the policy number, please?
[CUSTOMER][NEUTRAL] 0256.
[CUSTOMER][NEUTRAL] 7172.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII] direct line.
[AGENT][NEUTRAL] OK. And the patient's name, date of birth?
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] OK, patient's name, date of birth?
[CUSTOMER][NEUTRAL] Hello, sorry.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Hello.
[AGENT][NEUTRAL] Yes, can you hear me?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] What is the patient's name, date of birth?
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] Lo
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. And what was the date of service and the amount of the charge?
[CUSTOMER][NEUTRAL] $407 even.
[AGENT][NEUTRAL] What is the date of service?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you, one moment.
[AGENT][NEUTRAL] What's the name of the provider's office?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] PJ Sampson Community Hospital.
[AGENT][NEUTRAL] OK, I'm showing this claim processes benefits payable under the certificates limited those outlined in the schedule of benefits. This is not a covered loss under the plan, therefore benefits are not payable.
[AGENT][NEUTRAL] So per the patient's policy, it's not a covered, correct.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] So this is non-covered, right?
[CUSTOMER][NEUTRAL] Yeah, just a moment please. What is the process date?
[AGENT][NEUTRAL] Uh, [PII].
[CUSTOMER][NEUTRAL] [PII] as per patient plan.
[CUSTOMER][NEUTRAL] It means the bill the CPT is noncore, right.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] What's the claim number?
[AGENT][NEUTRAL] Claim number is 3556002.
[CUSTOMER][NEUTRAL] What is the all reference?
[AGENT][NEUTRAL] You may use my name in today's date as call reference.
[CUSTOMER][NEUTRAL] spell your name please.
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, [PII], is there anything else I can assist you with today?
[CUSTOMER][NEUTRAL] For the same patient I have.
[CUSTOMER][NEUTRAL] Other date of service.
[AGENT][NEUTRAL] OK data service mount on the charge.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] $185 saving.
[AGENT][NEUTRAL] And that claim process not a covered diagnostic test.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] You said uh bills is not covered under the patient's plan, right?
[AGENT][MIXED] Correct, not a covered diagnostic test.
[CUSTOMER][NEUTRAL] Sure, what is the process date?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] What's the claim number for this?
[AGENT][NEUTRAL] 3571822
[CUSTOMER][NEUTRAL] Just a
[CUSTOMER][POSITIVE] OK thank you [PII]. Thank you for staying with your patience.
[CUSTOMER][NEUTRAL] And there is any call tri claim timely filing limit will be cut to claim.
[AGENT][NEUTRAL] Repeat. Say again.
[CUSTOMER][NEUTRAL] Make character claim timely filing limit.
[AGENT][NEUTRAL] No, there's no time limit for corrected claim, but you must submit a letter stating the reason for the correction.
[CUSTOMER][POSITIVE] OK sure, thank you.
[AGENT][NEUTRAL] Mhm.