AccountId: 011433970860
ContactId: f70ced05-a561-4211-b85b-bad154f9d9ad
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 353510 ms
Total Talk Time (AGENT): 91547 ms
Total Talk Time (CUSTOMER): 52802 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/08/f70ced05-a561-4211-b85b-bad154f9d9ad_20250108T18:32_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII] calling from product office. I need to claim status.
[AGENT][NEUTRAL] OK, [PII], I can help you with claim status. What is your callback number please sir?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And then what's the patient's name, please?
[CUSTOMER][NEUTRAL] Patient name is [PII].
[AGENT][NEUTRAL] And what's [PII]'s date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And then what is the [PII]'s policy number?
[CUSTOMER][NEUTRAL] 01
[CUSTOMER][NEUTRAL] 650
[CUSTOMER][NEUTRAL] 823.
[AGENT][NEUTRAL] OK, let me pull in her policy for us.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, what is the date of service for the claim?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, and then what is the charge amount?
[CUSTOMER][NEUTRAL] $120.
[AGENT][NEUTRAL] OK, and what is the charge after the primary insurance paid their part?
[CUSTOMER][NEUTRAL] Uh, $30.
[AGENT][NEUTRAL] $30.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Oh thank you and then what is the name of the facility you're calling [PII]?
[CUSTOMER][NEUTRAL] South Central Medical and Resorts Center.
[AGENT][NEUTRAL] OK, I'm gonna put you on a brief hold while I pull this policy and claim up for you and I will be right back.
[CUSTOMER][NEUTRAL] Sure, OK.
[AGENT][POSITIVE] Thank you, sir.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Hi [PII], this is [PII] back with you. So I did find the claim. The claim number is 268-4332.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And the claim was denied because office visits are not covered under the policy.
[CUSTOMER][NEUTRAL] 1 2nd.
[CUSTOMER][NEUTRAL] Uh sorry, uh, what is the reason for the office visit?
[AGENT][NEUTRAL] Office visits are non-covered.
[CUSTOMER][NEUTRAL] Uh, when it was, uh, denied?
[AGENT][NEUTRAL] On [PII].
[CUSTOMER][NEUTRAL] Thank you. And what is the time depending limit? Like uh claiming, timely limit?
[AGENT][NEGATIVE] There isn't a timely filing limit.
[AGENT][NEUTRAL] But the claim has been filed.
[CUSTOMER][NEUTRAL] Thank you. Can I get the call reference number?
[AGENT][NEUTRAL] You have filed the claim on we received it on [PII].
[CUSTOMER][NEUTRAL] You know.
[CUSTOMER][NEUTRAL] Thank you. Can I get the call reference number?
[AGENT][NEUTRAL] Yes, you can use my name. It's [PII] and today's date.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're very welcome, [PII]. Is there anything else I can help you with?
[CUSTOMER][POSITIVE] Nothing, that's all. Thank you so much.
[AGENT][POSITIVE] Alright well you have a good day and thank you for calling APL sir.
[CUSTOMER][POSITIVE] Thank you. Bye.
[AGENT][NEUTRAL] Mm bye-bye.