AccountId: 011433970860
ContactId: ec68cd4e-bd5d-4f7f-ab13-d9e36818e438
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 141720 ms
Total Talk Time (AGENT): 68628 ms
Total Talk Time (CUSTOMER): 36168 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/23/ec68cd4e-bd5d-4f7f-ab13-d9e36818e438_20250123T15:59_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] And thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII] and I'm calling for claim status.
[AGENT][NEUTRAL] I'm sure [PII], I can assist you with claim status. Um, first, I'll need a good callback number in case we're disconnected.
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[AGENT][NEUTRAL] Thank you. Now, I need the policy number, please.
[CUSTOMER][NEUTRAL] It's 02512923.
[AGENT][NEUTRAL] OK. Thank you. Now, please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] Hey, now I need the date of service and bill charges on the client.
[CUSTOMER][NEUTRAL] Date of service is [PII]. And the billed amount is $340.52.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, yes, ma'am. We did receive that claim on [PII].
[AGENT][NEUTRAL] Um, it processed on [PII].
[AGENT][NEUTRAL] The claim number is 351-6245.
[AGENT][NEUTRAL] And the claim is denying because um on the first line, which is for an office visit, office visits are not covered under the policy. And the second line is denying because according to the primary ELB, the primary insurance covered the charge in full.
[CUSTOMER][NEUTRAL] OK, um, and is the office visit patient's responsibility?
[AGENT][NEUTRAL] Yes, ma'am, it is.
[CUSTOMER][NEUTRAL] OK. All right. And what was your name again, please?
[AGENT][NEUTRAL] Um, it's [PII]. It's spelled [PII] and my last initial is [PII]. Is there anything else that I can assist you with?
[CUSTOMER][NEUTRAL] Is the reference number
[AGENT][NEUTRAL] The reference number is my name and today's date.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] OK, thank you, [PII], for calling APL. You have a great rest of your day. Mm bye.
[CUSTOMER][NEUTRAL] Bye.