AccountId: 011433970860
ContactId: e3a581be-482f-42bc-ba6a-ce07e8e72d27
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 362500 ms
Total Talk Time (AGENT): 93579 ms
Total Talk Time (CUSTOMER): 110690 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/27/e3a581be-482f-42bc-ba6a-ce07e8e72d27_20250327T17:04_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yeah, hi, [PII]. This is [PII]. I'm calling for the provider to check on additional information about a claim that has been denied. Please note this call will be monitored and recorded for quality and training purposes. How are you doing today, [PII]?
[AGENT][POSITIVE] I'm doing good [PII] how are you doing today sir?
[CUSTOMER][POSITIVE] Yeah, yeah, I'm doing great, [PII]. Thank you so much for asking.
[AGENT][POSITIVE] Thank you, and I can help you with the claim status. Can you please give me your callback number just in case our call is disconnected?
[CUSTOMER][NEUTRAL] Uh, sorry, it is [PII], and it is a direct line.
[AGENT][NEUTRAL] Thank you. And then what is the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Sure, the patient's name was?
[CUSTOMER][NEUTRAL] [PII]. And the date of birth is, it's [PII]. And the policy number is, it's 01631918.
[AGENT][NEUTRAL] OK, let me pull up that policy real quick.
[CUSTOMER][NEUTRAL] So.
[AGENT][NEUTRAL] OK, and then what is the date of service?
[CUSTOMER][NEUTRAL] So, the data service is [PII] with the total bill amount of its $275.50.
[AGENT][NEUTRAL] OK, and then what is the uh charge amount after the primary insurance paid their part?
[CUSTOMER][NEUTRAL] Uh, yes. So the
[CUSTOMER][NEUTRAL] Charge amount of the primary insurance pay is.
[CUSTOMER][NEUTRAL] OK. OK. It is $40 even.
[AGENT][NEUTRAL] OK and then can you please give me the facility name?
[CUSTOMER][NEUTRAL] Uh, sure. Uh, the facility name was, uh, Carolina Orthopedic and Neurosurgical Associates PA.
[AGENT][NEUTRAL] OK, I'm gonna put you on a brief hold while I look up this claim, and I will be right back sir.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK [PII], this is [PII] back with you again. I have the claim for you. The claim number is 3569022.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And the claim was denied as non-covered under the patient's policy.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Got it. Thank you so much. And may I know the member's policy, uh, name of the member's policy?
[AGENT][NEUTRAL] Yes, the policy name is Medlink.
[CUSTOMER][NEUTRAL] Got it. Uh, can I have the type it's, uh, some more PPRPs.
[AGENT][NEUTRAL] OK, let me look up that real quick for you.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK, so the claim was received on [PII] and processed on [PII].
[CUSTOMER][POSITIVE] Got it. Thank you so much.
[CUSTOMER][NEUTRAL] To for the information.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] Is there anything else I can help you with, [PII], before we go?
[CUSTOMER][NEUTRAL] Uh yeah, yes, the business policy in name is meddling and uh it is uh uh PPO, POS or HMO or it's a supplemental plan.
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] It's a supplement.
[CUSTOMER][POSITIVE] Got it. Thank you so much. Yup. Oh, got it. Thank you so much. And for this one, can I have the card reference number for our call today?
[AGENT][NEUTRAL] Yes, you can, you can use my name [PII] and today's date.
[CUSTOMER][NEUTRAL] [PII]?
[CUSTOMER][POSITIVE] 214. Got it. Thank you so much, [PII]. Have a great day and good for yourself, stay safe.
[AGENT][POSITIVE] You too. Thank you for calling APL [PII]. You have a wonderful day too bye bye.
[CUSTOMER][NEUTRAL] Yeah.