AccountId: 011433970860
ContactId: f7d01a59-04d2-4af9-9750-90c9b3d3b0a1
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 291579 ms
Total Talk Time (AGENT): 65008 ms
Total Talk Time (CUSTOMER): 83806 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/16/f7d01a59-04d2-4af9-9750-90c9b3d3b0a1_20250516T16:32_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey, hi, [PII]. My name is [PII] and I'm calling from provider's office and I need to check on a claim status for a patient. So could you help me with that?
[AGENT][POSITIVE] Yes, I can help with claim status play. Do you have a good callback number?
[CUSTOMER][NEUTRAL] Yes, it's gonna be [PII], and it's my direct line.
[AGENT][NEUTRAL] And do you have the policy number of the patient?
[CUSTOMER][POSITIVE] Yes, I do, and it is gonna be.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] All right. It's 02069892.
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] Patient's name is uh [PII], and date of birth is [PII].
[AGENT][NEUTRAL] Day of service and bill charges?
[CUSTOMER][NEUTRAL] Data service on.
[CUSTOMER][NEUTRAL] [PII] with the bill charges of $578 even.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] OK, it looks like we received that claim on.
[AGENT][NEUTRAL] [PII]. Process [PII].
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] Office visits are not covered under the policy.
[AGENT][NEUTRAL] And then
[AGENT][NEUTRAL] The other charges, uh, looks like were applied towards the calendar year deductible.
[CUSTOMER][NEUTRAL] It means this is processed and paid as a deductible.
[AGENT][NEUTRAL] The office visit charge is not covered under the policy.
[AGENT][NEUTRAL] And then the other charge was applied towards the deductible.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] Let me check one moment.
[AGENT][NEUTRAL] So 3344 went towards the deductible.
[AGENT][NEGATIVE] And then the 3:35 for the office visit is denied.
[CUSTOMER][NEUTRAL] All right. One moment.
[CUSTOMER][NEUTRAL] All right. Thank you for patiently waiting on the line. And may I know that uh the offer was which is uh non-covered on the patient's plan or provider's contract?
[AGENT][NEUTRAL] Not covered under the patient's plan.
[CUSTOMER][NEUTRAL] Not covered under the patient's plan. All right. Got it.
[CUSTOMER][NEUTRAL] And may I know the patient's plan type?
[AGENT][NEUTRAL] And type is.
[CUSTOMER][NEUTRAL] online.
[AGENT][NEUTRAL] Medlink 6.
[CUSTOMER][NEUTRAL] Uh, well, it's like an HMO PPO, EPO RPOs like that.
[AGENT][NEUTRAL] The secondary policy, none of those, it's the secondary policy.
[CUSTOMER][NEUTRAL] Secondary policy. All right. One moment, let me check with that again.
[CUSTOMER][NEUTRAL] All right then. Thank you for patiently waiting on the line. Well, can I get the claim number for this patient?
[AGENT][NEUTRAL] 359-893-0.
[CUSTOMER][POSITIVE] All right, got it. Can I get your name and the reference number and thank you for assisting with this information.
[AGENT][NEUTRAL] Um, my name is [PII]. First initial to last name, [PII], and then my name and today's date would be the reference number.
[CUSTOMER][POSITIVE] Thank you, [PII]. Thank you for your assistance and you have a wonderful day. Bye now and take care.
[AGENT][POSITIVE] Thank you for calling APL. You too. Bye-bye.
[CUSTOMER][NEUTRAL] Uh