AccountId: 011433970860
ContactId: d808e471-02f5-44fb-869b-9e4bcfeb159c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 260178 ms
Total Talk Time (AGENT): 106581 ms
Total Talk Time (CUSTOMER): 76019 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/27/d808e471-02f5-44fb-869b-9e4bcfeb159c_20250327T19:08_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yeah, hi, my name is [PII] calling from product office to check on clients and how are you doing today?
[AGENT][POSITIVE] I'm good. What is your name again? I'm so sorry.
[CUSTOMER][NEUTRAL] My name is [PII], and could you please spell out your name for me?
[AGENT][NEUTRAL] OK, before that, spell your name for me?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you, [PII]. My name is spelled [PII] Last initial is [PII]. What is your callback number?
[CUSTOMER][NEUTRAL] It's [PII]. It's a direct line.
[AGENT][NEUTRAL] What is the policy number? Thank you.
[CUSTOMER][NEUTRAL] Policy number is 21483663.
[AGENT][NEUTRAL] OK, that was 2148363. Thank you. Verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Patient's name, [PII]. Date of birth, [PII].
[AGENT][NEUTRAL] OK, one moment. The member pulled up for you again. You're calling for claim status. I can assist you and also [PII], you can check claim status and retrieve ELBs by checking our website at [PII]
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] And [PII], uh, what is that date of service and total charge amount please?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] Uh yes, the date of service is on [PII] with the total charge of $190 even. And [PII], uh, uh, your line is in and out. I couldn't hear your voice properly.
[AGENT][NEUTRAL] Maybe.
[AGENT][NEUTRAL] OK. You can check claim status and obtain ELBs on our secure website at [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, now in regards to that claim that was [PII] $190 total, um, if you could verify if that was procedure code 99213.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. The claim was received and it denied as office visits are not covered by this policy. Again, this policy does not cover office visits.
[CUSTOMER][NEUTRAL] Yeah, OK, fine. And could you please provide me the claim received and denied it?
[AGENT][NEUTRAL] Of course. The claim was received on [PII] and processed and denied [PII].
[CUSTOMER][NEUTRAL] You can. May I know the patient's policy type?
[AGENT][NEUTRAL] This is a supplemental medical policy.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, supplement policy and it does not cover office visit, right?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] OK, give me a quick second. Let me have a look on my end.
[CUSTOMER][NEUTRAL] Yeah, OK, fine. And may I know the claim number.
[AGENT][NEUTRAL] Claim number is 357-592-6.
[CUSTOMER][NEUTRAL] 926.
[CUSTOMER][NEUTRAL] OK. Thank you so much. And for this, could you please send a copy of an EUB through fax.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Could you please send a copy of an EOB through fax?
[AGENT][NEUTRAL] Um, you're able to get the ELBs from the website at [PII].
[AGENT][NEUTRAL] At [PII].
[CUSTOMER][POSITIVE] OK, then. Thank you so much, [PII]. Could you please provide me the call reference number?
[AGENT][NEUTRAL] Uh, we do not provide
[AGENT][NEUTRAL] Reference numbers [PII], you can use my name and today's date. My last initial is [PII] like [PII].
[CUSTOMER][NEUTRAL] you
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][POSITIVE] Yeah, OK. Thank you so much, [PII] and thank you so much for your assistance. Have a great day. Bye-bye.
[AGENT][POSITIVE] Thank you for calling APL. Take care as well. Bye bye.