AccountId: 011433970860
ContactId: ee77b861-c614-4763-9c63-c9f3c965b90d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 223929 ms
Total Talk Time (AGENT): 49145 ms
Total Talk Time (CUSTOMER): 87839 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/27/ee77b861-c614-4763-9c63-c9f3c965b90d_20250127T21:35_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. This is [PII]. I'm calling for the provider to check in additional information about the claim that has been denied. Please note this call will be monitored and recorded for quality and training purpose.
[AGENT][NEUTRAL] Thanks, [PII]. Can you give me the policy number and the claim number?
[CUSTOMER][NEUTRAL] Yes, the policy number, it is 017918887 M as in Mike L as in Lima, 8.
[AGENT][POSITIVE] And a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] It's [PII] and it is a direct line.
[AGENT][NEUTRAL] OK. What's the patient's name and date of birth?
[CUSTOMER][NEUTRAL] It's [PII] and the date of birth, it's [PII].
[AGENT][NEUTRAL] OK, thank you for that information and um what's the claim number?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Claim number for this one it shows.
[CUSTOMER][NEUTRAL] Just one second, it's loading.
[CUSTOMER][NEUTRAL] It is 3546417.
[AGENT][NEUTRAL] What is your question regarding this claim?
[CUSTOMER][NEUTRAL] My question is, the CPT code 99214. That code doesn't pay anything. Could you able to provide me the additional clarification of the address, sir?
[AGENT][NEUTRAL] You gave me claim number 3546417?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Under policy number 017918887.
[CUSTOMER][NEGATIVE] No, policy number, it shows, just one second, it shows.
[CUSTOMER][NEUTRAL] 025
[CUSTOMER][NEUTRAL] 54591.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Do you have a copy of the explanation of benefits in front of you?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] On the back, can you read the remark code for that procedure code 99214?
[CUSTOMER][NEUTRAL] It shows one and uh it shows non-covered. So, can you confirm that it is not a cover service under the patient's plan, providers contract or pay guidance it comes under which one?
[AGENT][NEUTRAL] The policy, it's not covered under the patient's policy.
[CUSTOMER][NEUTRAL] May I know the patient's planning?
[AGENT][NEUTRAL] It's a supplemental, this is a Metlink policy.
[CUSTOMER][NEUTRAL] Med link, just one second.
[CUSTOMER][NEUTRAL] Middling supplement policy, I'm right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK. So for this one,
[CUSTOMER][NEUTRAL] Can I get the call reference number?
[AGENT][NEUTRAL] It's my name and today's date, [PII] First initial last name is [PII] and any other questions for us?
[CUSTOMER][POSITIVE] No, I'm good enough for the information. Have wonderful day. Bye-bye.
[AGENT][POSITIVE] You're welcome thanks for calling APL. Have a good day as well.
[CUSTOMER][NEUTRAL] You too.