AccountId: 011433970860
ContactId: dc8d1d35-7373-4495-8741-a30347fde512
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 328440 ms
Total Talk Time (AGENT): 140514 ms
Total Talk Time (CUSTOMER): 67215 ms
Interruptions: 1
Overall Sentiment: AGENT=0.6, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/12/dc8d1d35-7373-4495-8741-a30347fde512_20250512T14:50_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII] calling from provider's office to check on our client status. Can you please help me with that?
[AGENT][NEUTRAL] OK, [PII], you have one claim to check status on, is that correct?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] Yes, ma'am. I can help you. And what is your callback number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you and the member's policy number?
[CUSTOMER][NEUTRAL] 02389384.
[AGENT][NEUTRAL] Thank you one moment please while I get the member's information pulled up.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Have a.
[AGENT][NEUTRAL] And [PII], any information that I provide for you today will be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] It's [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Hello.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] this one.
[AGENT][NEUTRAL] And what is the data service and total bill amount?
[CUSTOMER][NEUTRAL] Like
[CUSTOMER][NEUTRAL] It's [PII] for the bill amount $483 even.
[AGENT][NEUTRAL] 483, is that correct?
[CUSTOMER][POSITIVE] That's right.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, so I do show that this claim was received.
[AGENT][NEGATIVE] The received date was [PII]. It was processed and denied on [PII].
[AGENT][NEUTRAL] The claim number is 358.
[AGENT][NEUTRAL] 0781.
[AGENT][NEUTRAL] Code 99244 was denied as office visits are not covered by the policy. The member's policy does not cover office visits, and code 99406 was denied as the policy provides no benefits for the treatment of conditions other than a sickness or injuries defined by the policy.
[AGENT][NEUTRAL] And if you need a copy of this explanation of.
[CUSTOMER][NEUTRAL] OK. I got it. Uh, can you please let me
[AGENT][NEUTRAL] Yes, well, go ahead with your question first.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yeah, can you please let me know the allowed visits?
[AGENT][NEGATIVE] There's not a number of lab visits. This is not covered under her policy. Office visits are not covered.
[AGENT][NEUTRAL] This is a supplemental policy.
[CUSTOMER][NEUTRAL] OK, can I, can you please provide me the policy name?
[AGENT][NEUTRAL] Medlink, it's a supplemental policy.
[CUSTOMER][NEUTRAL] Uh, can you please spell that for me, please?
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] And if you need a cop.
[CUSTOMER][NEUTRAL] Can you please let me know the member's plan name?
[AGENT][NEUTRAL] Med [PII]. I just spelled it for you. [PII]
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Yes, I got it. Thank you so much for the information. Can you please provide the copy of EU fax for us?
[AGENT][NEUTRAL] You're welcome. And it's
[AGENT][NEUTRAL] Yes, ma'am. I can provide you a website that you can print it from, from our portal by going to [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, now that you have the claim number, you should be able to print that directly.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. Can you please uh repeat the portal?
[AGENT][POSITIVE] [PII].
[CUSTOMER][NEUTRAL] For the link please.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Got it, thank you so much for the information. Can I get the call reference number for this thing?
[AGENT][POSITIVE] Yes, you would use my name that I gave you along with today's date.
[CUSTOMER][NEUTRAL] Can you please spell your name for me?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Got it, [PII]. Thanks for assisting. Have a great day. Take care. Bye-bye.
[AGENT][POSITIVE] Oh, you're welcome. Yes, ma'am. So if that's all I can help you with, thank you again for calling APL and I hope you have a nice day also.