AccountId: 011433970860
ContactId: dd232f66-fd88-47fd-8db9-7db58023a106
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 225990 ms
Total Talk Time (AGENT): 64192 ms
Total Talk Time (CUSTOMER): 75827 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/03/dd232f66-fd88-47fd-8db9-7db58023a106_20250403T20:56_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh, my name is [PII] calling as a provider, calling to check the status of a claim.
[AGENT][NEUTRAL] OK, I'm happy to check on a claim. Do you have the policy number?
[CUSTOMER][NEUTRAL] 01821740
[AGENT][POSITIVE] Thank you for that. One moment.
[AGENT][NEUTRAL] Patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] Patient's name is [PII]. Date of birth [PII].
[AGENT][POSITIVE] Thank you. Data service.
[CUSTOMER][NEUTRAL] The service is [PII].
[CUSTOMER][NEUTRAL] And the total amount billed is $676.
[AGENT][NEUTRAL] Alright, not showing any claims on file for 210 and 25.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, so I'm showing.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] We received some type of explanation of benefit.
[CUSTOMER][NEUTRAL] And it has a reference number on it of 02440266.
[AGENT][NEUTRAL] I'm sorry, 0244.
[CUSTOMER][NEUTRAL] 0266
[AGENT][NEUTRAL] Let me see what it.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] I'm sorry, it has a claim number of 3574583.
[AGENT][NEUTRAL] Oh, OK. Give me just one moment.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] I apologize. My brain must not be all there. It was processed under a different policy. The policy number that you gave me is not the active one. Do you need the active policy number?
[CUSTOMER][NEUTRAL] Um, I'm showing it on this EOB of 02440266.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, so it looks like the claim was denied. It's stating services are not um covered when performed in a doctor's office or clinic.
[CUSTOMER][NEUTRAL] OK, so they don't have coverage for um doctor visits?
[AGENT][POSITIVE] Mhm. Correct.
[CUSTOMER][NEUTRAL] Mhm. OK. I get that covered.
[CUSTOMER][NEGATIVE] Read that verbage to me again. Services are not covered when performed.
[AGENT][NEUTRAL] In a doctor's office or clinic?
[CUSTOMER][NEUTRAL] or clinic.
[CUSTOMER][NEUTRAL] Alright, thank you and may I have a reference number for the call?
[AGENT][NEUTRAL] Call references my name with my last initial in today's date. My name again is [PII], that's [PII], last initial [PII] like [PII].
[CUSTOMER][NEUTRAL] This
[CUSTOMER][POSITIVE] All right thank you you have a good day.
[AGENT][NEUTRAL] You too, bye bye.