AccountId: 011433970860
ContactId: fa4b6b1c-d14e-40c0-ae86-498fbcbb2798
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 180940 ms
Total Talk Time (AGENT): 81358 ms
Total Talk Time (CUSTOMER): 57697 ms
Interruptions: 0
Overall Sentiment: AGENT=2.7, CUSTOMER=1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/30/fa4b6b1c-d14e-40c0-ae86-498fbcbb2798_20250130T21:33_UTC.wav
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[AGENT][NEUTRAL] Hi, thank you for calling APL. This is [PII]. How can I help you today?
[CUSTOMER][NEUTRAL] Yeah, hi, good afternoon. My name is [PII] and last term initial [PII]. I'm calling from provider's office regarding claim status.
[AGENT][POSITIVE] OK, yeah, I'd love to help you with that today and.
[AGENT][NEUTRAL] May I get that policy number please?
[CUSTOMER][NEUTRAL] Yeah, sure.
[CUSTOMER][NEUTRAL] 02252690 M for Mary, L for Lima, 8.
[AGENT][POSITIVE] Perfect. And while I'm getting that policy pulled up, do you mind if I also grab a good callback number?
[CUSTOMER][NEUTRAL] [PII]. It is a direct line.
[AGENT][POSITIVE] Perfect. [PII], I think we just spoke a moment ago.
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] Did you just call here a little bit ago too?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] I, I just helped you out a moment ago. How are you doing? You still doing good?
[CUSTOMER][POSITIVE] Yeah, good. What about you?
[AGENT][POSITIVE] Always wonderful my friend. Thanks for asking.
[AGENT][NEUTRAL] And [PII], can you do me the favor of verifying your member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Yeah, sure. The patient name is [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] Perfect. I do see [PII] here. And do you have the date of service you want me to look at this claim with or the claim number?
[CUSTOMER][NEUTRAL] Uh, I can provide the date of service and with all amount. I don't have any claim number.
[AGENT][POSITIVE] No worries.
[CUSTOMER][NEUTRAL] OK. Um, the date of service is [PII] and the total charge $542 even.
[AGENT][POSITIVE] And I'm ready when you are.
[AGENT][POSITIVE] Wonderful. OK, perfect.
[AGENT][NEUTRAL] 6751.
[AGENT][NEUTRAL] Would you be able to verify for me, please, the name of the facility on file for this claim?
[CUSTOMER][NEUTRAL] Gastro Health LLC.
[AGENT][POSITIVE] Perfect, thank you. I am seeing your claim here. It looks like we received it 1104-2024, uh, the
[AGENT][NEUTRAL] I'm so sorry. 11-4-2024, we processed at 1106-2024. I have your claim number listed as 352-6751.
[AGENT][NEGATIVE] And I do show that this claim denied. The reason stating is that office visits are not covered by the above number policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][POSITIVE] Thank you so much. And I have this, OK. Can you please spell your name?
[AGENT][NEUTRAL] Yes, [PII], first initial, last name, [PII].
[CUSTOMER][POSITIVE] Yeah, thank you, [PII], thank you for giving this information and happy weekend.
[AGENT][POSITIVE] You too take care [PII] thanks for calling APL.
[CUSTOMER][NEUTRAL] Yeah, bye-bye.
[AGENT][NEUTRAL] Bye-bye.