AccountId: 011433970860
ContactId: e752d493-59a1-4c78-b79a-eb2c1df49a5a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 370600 ms
Total Talk Time (AGENT): 105519 ms
Total Talk Time (CUSTOMER): 79417 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/22/e752d493-59a1-4c78-b79a-eb2c1df49a5a_20250522T18:27_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Uh, hi, this is [PII] calling from provider's office to check on a claim status.
[AGENT][NEUTRAL] OK, [PII], I can help you with claim status. May I please get your callback number just in case the call is disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And then what is the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Yes, it is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the policy number, please?
[CUSTOMER][NEUTRAL] 01893575, M as in Michael, L as in Lima, 8.
[AGENT][NEUTRAL] OK, let me look that up.
[AGENT][NEUTRAL] OK, and then may I please have the data service and the charge amount?
[CUSTOMER][NEUTRAL] Yes, it is [PII] and the bill amount is $106.38.
[AGENT][NEUTRAL] OK, and what was that data service again?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, and the charge was $100.38?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, and what are the charges after the primary insurance paid their part?
[CUSTOMER][NEUTRAL] Uh, $43.45.
[AGENT][NEUTRAL] Thank you. And then what is the name of the facility you're calling from?
[CUSTOMER][NEUTRAL] Westlake Dermatology.
[AGENT][NEUTRAL] OK, I'm gonna put you on a quick hold while I look up this claim for you, Ms. [PII], and I'll be right back.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Um
[AGENT][POSITIVE] Thank you for holding for me. I've got the claim information for you.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] Number is 359-419-5.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And the claim has been denied. Are you there?
[AGENT][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Yes, yes, I'm here.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, I've got the claim number is 359-419-5.
[AGENT][NEUTRAL] And the claim has been denied because office visits are not covered under the patient's policy.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, like now the balance will be billed to the patient?
[AGENT][NEGATIVE] We don't give patient responsibility.
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] Uh, like the, now, uh, will that be the
[CUSTOMER][NEUTRAL] Providers write off for the patient's responsibility. I have a question on the remaining balance.
[AGENT][NEUTRAL] Yes, we don't give patient responsibility that's determined by the provider.
[CUSTOMER][NEUTRAL] OK. Like if you disagree with the decision, we need to appeal.
[AGENT][NEUTRAL] You can appeal if you want to, but office visits are not covered under the patient's policy.
[AGENT][NEUTRAL] And the remaining balance is determined by the provider what to do with that.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] OK, OK, thank you so much. Yeah, and can you also please provide me the reference number for the call today.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, you can use my name and today's date as your call reference number.
[AGENT][NEUTRAL] My name is [PII]
[CUSTOMER][NEUTRAL] Can you
[CUSTOMER][POSITIVE] OK. Thank you so much for providing me with everything patiently. Have a great day. Bye for now.
[AGENT][POSITIVE] You too. Thank you, Ms. [PII]. You have a wonderful weekend and thank you for calling APL.
[AGENT][NEUTRAL] Bye bye, ma'am.
[CUSTOMER][POSITIVE] Thank you. Bye-bye.
[CUSTOMER][NEUTRAL] OK