AccountId: 011433970860
ContactId: d7ec97d6-5d66-4e9b-8815-5e9c90b5cc6b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 206309 ms
Total Talk Time (AGENT): 74524 ms
Total Talk Time (CUSTOMER): 84118 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/18/d7ec97d6-5d66-4e9b-8815-5e9c90b5cc6b_20250218T19:47_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thanks for calling APL. This is speaking. May I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. And first you share to my last name [PII]. I'm calling from provider's office. I need to check claim status. Can you help me with that?
[AGENT][NEUTRAL] Sure, I can verify claim status for you and [PII], what is the policy number, please?
[CUSTOMER][NEUTRAL] It is 1126033 M as in Mike, L as in Lima, number 5.
[AGENT][NEUTRAL] Thank you. And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] Yes, my callback number is [PII]. It's a direct line.
[AGENT][NEUTRAL] OK, and verify the patient's name, date of birth.
[CUSTOMER][NEUTRAL] And the patient's name is [PII], and date of birth is [PII].
[AGENT][NEUTRAL] OK. And what was the date of service and the amount of the charge?
[CUSTOMER][NEUTRAL] Date of service is [PII] and charge amount is $400 even.
[AGENT][NEUTRAL] OK, and what's, what's the balance after primary?
[CUSTOMER][NEUTRAL] It is $50 even.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] OK, and what's the name of the provider's office?
[CUSTOMER][NEUTRAL] And it is [PII] MDP.
[AGENT][NEUTRAL] OK, and while I'm looking at claim information, just to let you know we do have an online service center where providers can check claim status as well as print out the ELD. That site is at [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] And I show this claim processed as office visits are not covered per the patient's policy.
[CUSTOMER][NEUTRAL] OK, perfect. And can you please tell me the name of the plan which the member have?
[AGENT][NEUTRAL] Uh, it looks like they had um Metlink.
[CUSTOMER][NEUTRAL] know.
[CUSTOMER][NEUTRAL] So, is it meddling supplemental gap policy?
[AGENT][NEUTRAL] It's a secondary supplemental policy.
[CUSTOMER][NEUTRAL] And can you please tell me the received date and the denied date?
[AGENT][NEUTRAL] Uh, claim received [PII], processed on [PII].
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] And can you please help me with the claim number for this claim?
[AGENT][NEUTRAL] Claim number is 3530026.
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] You.
[CUSTOMER][POSITIVE] Wonderful. And
[CUSTOMER][NEUTRAL] May I know your name, please?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Uh, your name
[AGENT][NEUTRAL] It's [PII]
[CUSTOMER][POSITIVE] Wonderful. Thank you so much. And [PII], may I have the reference number for the call?
[AGENT][NEUTRAL] Uh, we don't give reference numbers. If you like, you may use my name in today's date.
[CUSTOMER][POSITIVE] Perfect. Thank you so much for your help, [PII], and have a great day. Bye-bye.
[AGENT][POSITIVE] Alright, you're welcome. Thanks for calling APL. Bye.