AccountId: 011433970860
ContactId: f89925f6-70dc-46d9-ae1b-5a6d7412faac
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 315809 ms
Total Talk Time (AGENT): 130488 ms
Total Talk Time (CUSTOMER): 88336 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/10/f89925f6-70dc-46d9-ae1b-5a6d7412faac_20250310T20:31_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, I'm [PII] and I'm calling from Emmi Clinic. Are you on claims?
[AGENT][NEUTRAL] What is your name?
[CUSTOMER][NEUTRAL] And just
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yeah, yeah.
[AGENT][NEUTRAL] What is your callback number [PII]?
[CUSTOMER][NEUTRAL] And that's uh [PII].
[AGENT][NEUTRAL] What is the policy number, please?
[CUSTOMER][NEUTRAL] 02419.
[CUSTOMER][NEUTRAL] 274
[AGENT][NEUTRAL] OK, let me repeat that to you, [PII], as I heard 02419274.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Yeah, that's correct.
[AGENT][NEUTRAL] And verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Uh, one since [PII].
[AGENT][NEUTRAL] OK, thank you very much for the verification process and again you're calling for claim status, is that correct?
[CUSTOMER][POSITIVE] Yeah, yeah, yeah, they got plan.
[AGENT][NEUTRAL] OK, I can assist you with claim status. You can also check claim status by visiting our secure portal at [PII], and on that website you'll be able to obtain EVs. What is that date of service and the total charge amount please, [PII]?
[CUSTOMER][NEUTRAL] That's uh [PII].
[CUSTOMER][NEUTRAL] Charge is 769 7691.
[AGENT][NEUTRAL] OK, 769 even that's [PII], is that correct? Just wanna make sure of that.
[CUSTOMER][NEUTRAL] Yeah, yeah, that's what.
[AGENT][NEUTRAL] OK thank you one moment.
[AGENT][NEUTRAL] And can you verify the procedure code or codes billed for this service state for the number?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] That's uh
[CUSTOMER][NEUTRAL] 80053
[CUSTOMER][NEUTRAL] 8006183036
[CUSTOMER][NEUTRAL] 850253615
[AGENT][POSITIVE] Thank you very much for the information. I appreciate that. Give me one moment sir.
[AGENT][NEUTRAL] 23. OK, that shows that the claim was received and it denied, um, again services were denied per the policy. It did not cover any services or procedures inside the doctor's office or clinic.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] These services are not covered on the plan, right?
[AGENT][POSITIVE] Well, performed in the doctor's office or clinic, that is correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, can I have the same number?
[AGENT][NEUTRAL] Oh, certainly. It is 355-572-3.
[CUSTOMER][NEUTRAL] I'm I'm sitting there. I'm sitting there, can you start doing.
[AGENT][NEUTRAL] Of course. 355-5723.
[CUSTOMER][NEUTRAL] 355
[CUSTOMER][NEUTRAL] 355-5723, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK. And uh this is, uh, those denied charges or is it a patient responsibility or provider responsibility?
[AGENT][NEUTRAL] APL does not determine patients responsibility, [PII].
[CUSTOMER][NEUTRAL] OK, all right, uh, can I know the, uh, claim, uh, process please?
[AGENT][NEUTRAL] Of course one moment.
[AGENT][NEUTRAL] Yeah, the claim was received on [PII], excuse me, [PII] and processed on [PII].
[CUSTOMER][NEUTRAL] 243.
[CUSTOMER][NEUTRAL] Alright, uh, can you, uh, fax me your screen.
[AGENT][NEUTRAL] Um, you are able to obtain UBs from the website at [PII], but I will fax this over to you. What is your fax number, [PII]?
[CUSTOMER][NEUTRAL] Yeah, that is uh [PII].
[AGENT][NEUTRAL] Let me repeat that just to make sure I have it right. I have that as [PII].
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Yeah, yeah, that's good.
[AGENT][NEUTRAL] OK, I will get that faxed over to you, [PII]. Anything else I can assist you with?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, can I have a call from somebody.
[AGENT][NEUTRAL] Um, we do not use call reference numbers, but you can use my name. My last initial is [PII], first name is [PII], and today's date.
[CUSTOMER][NEUTRAL] Your name is uh [PII], right? OK.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Your name is uh [PII], correct?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, thank you, uh, that's all I need. Bye.
[AGENT][POSITIVE] Thank you for calling APL. Take care bye bye.