AccountId: 011433970860
ContactId: dab155cc-131b-4b44-8fd5-21bd0d500212
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 479880 ms
Total Talk Time (AGENT): 109260 ms
Total Talk Time (CUSTOMER): 104679 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=-1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/04/dab155cc-131b-4b44-8fd5-21bd0d500212_20250304T20:41_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Uh, hi, actually, I'm looking for a claim status. Could you please help me?
[AGENT][NEUTRAL] Yes sir, I can help you with claim status. Can I please get your name and your callback number?
[CUSTOMER][NEUTRAL] Yes, my name is [PII] and the initial of my last name is [PII], and my callback number is [PII] and extension is [PII].
[AGENT][POSITIVE] Thank you [PII], I appreciate you giving me that information. Can you please give me your.
[AGENT][NEUTRAL] Uh, patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Yes, the patient's name is [PII] and the date of birth is [PII].
[CUSTOMER][NEUTRAL] And policy number is 01615801 M as in Mary, L as in Lima, number 7.
[AGENT][POSITIVE] Thank you, sir. Let me look up that policy number real quick for you.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] OK, and then can you please give me the date of service for [PII]'s claim?
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] For $206.06.
[AGENT][NEUTRAL] Thank you, sir. And then what is the um charge amount after the primary insurance paid their part?
[CUSTOMER][NEUTRAL] Uh, actually, uh, the primary is the Aetna, and the, uh, bill to the second is the deductible. That is $61.26.
[AGENT][NEUTRAL] OK, thank you, sir. And then one last question, can you please give me the name of the facility you're calling from?
[CUSTOMER][NEUTRAL] Yes, the facility name is
[CUSTOMER][NEUTRAL] That is we and the primary provider of Rhode Island.
[AGENT][NEUTRAL] OK, I'm gonna put you on a brief hold, [PII], while I look up this claim for you and I'll be right back.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Yeah
[AGENT][POSITIVE] OK, thank you for holding for me, [PII]. I do have your claim.
[AGENT][NEUTRAL] The claim number is 342-218.
[AGENT][NEUTRAL] And the claim was denied because office visits are not covered by the policy.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then it also has a
[CUSTOMER][NEUTRAL] OK. So it is a patient responsibility?
[AGENT][NEUTRAL] Uh, sir, I can't give patient responsibility. That is, uh,
[AGENT][NEUTRAL] Determined by the provider.
[CUSTOMER][NEUTRAL] OK, so basically it is uh not a patient responsibility, but, uh, 99213 is not covered, right?
[AGENT][NEUTRAL] I can't give patient responsibility, sir, that's determined by the provider.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So, actually, we didn't receive the EOB. So could you please fax the EOB on our fax number? Is it possible for you?
[AGENT][NEUTRAL] I
[AGENT][POSITIVE] Absolutely, I can. Um, can you please give me your fax number?
[CUSTOMER][NEUTRAL] Uh, that is [PII].
[AGENT][NEUTRAL] OK, so the, let me repeat it back to you, sir. That is [PII]?
[CUSTOMER][NEUTRAL] Uh, I'm repeating again. It's [PII]. Attention to my name.
[AGENT][POSITIVE] Thank
[AGENT][POSITIVE] OK, thank you very much, [PII]. I'm gonna put you on a brief hold while I get that fax ready for you and I'll be right back sir.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Hi [PII], this is [PII] back with you again. I have that fax for the EOB on its way to you now, sir.
[CUSTOMER][NEUTRAL] OK, so could you please help me with your name and the reference number.
[AGENT][NEUTRAL] Yes, sir. My name is [PII]. It's [PII]
[AGENT][NEUTRAL] And you may use my name and today's date for your reference number.
[CUSTOMER][NEUTRAL] OK, so you faxed the UOB, right?
[AGENT][NEUTRAL] Yes sir, it's already been sent.
[CUSTOMER][POSITIVE] OK. Thank you so much. Sorry.
[AGENT][POSITIVE] You're welcome, [PII]. You have a good day and thank you for calling APL.
[AGENT][NEUTRAL] Bye bye sir.