AccountId: 011433970860
ContactId: fac232ee-3142-4844-9dca-0076992f8c8b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 256470 ms
Total Talk Time (AGENT): 73974 ms
Total Talk Time (CUSTOMER): 75844 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=-0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/03/fac232ee-3142-4844-9dca-0076992f8c8b_20250403T19:50_UTC.wav
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[AGENT][POSITIVE] And thank you for calling APR. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yeah, hi [PII]. My name is [PII] and I'm calling from provider's office to know the claim status.
[AGENT][NEUTRAL] I'm sure, [PII], I can assist you with claim status. Um, first, I'll need a callback number just in case we're disconnected.
[CUSTOMER][NEUTRAL] Yeah, my callback number is [PII] with [PII] [PII].
[AGENT][NEUTRAL] Thank you. Now, I need the policy number, please.
[CUSTOMER][NEUTRAL] Like
[CUSTOMER][NEUTRAL] Yeah, the policy number is 02450890.
[AGENT][NEUTRAL] And please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Patient's first name is [PII] and last name is [PII] and date of birth is [PII].
[AGENT][NEUTRAL] Thank you. Now I need the date of service and bill charges for the claim you're calling about.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Date of service is [PII] with the bill amount of $387 even.
[AGENT][NEUTRAL] OK, one moment, please.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Hey
[AGENT][NEUTRAL] OK. Yes, ma'am. I'm showing that we received this claim on.
[AGENT][NEUTRAL] Let's see. We received the claim on [PII].
[AGENT][NEUTRAL] The claim processed on [PII].
[AGENT][NEUTRAL] The claim number is 3,572,380.
[AGENT][NEUTRAL] And the claim is denying because the
[CUSTOMER][NEUTRAL] Can you please repeat the claim number once again?
[AGENT][NEUTRAL] Yes, the claim number is 357.
[AGENT][NEUTRAL] 2380.
[AGENT][NEUTRAL] OK. And the claim is denied because the place of service is not covered under the policy.
[CUSTOMER][NEUTRAL] Not covered under member's policy?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] So it is non-covered charges on the member's policy and we can bill the member, right?
[AGENT][POSITIVE] That's correct. Yes, ma'am.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, uh, so the place of service is not covered under the member's policy and it is not non, not covered benefit under it. Yeah, I just need the, uh, your name and the reference number for the call.
[AGENT][NEUTRAL] For the reference number, you can use my name and today's date. Um my name is [PII]. It's spelled [PII] My last initial is [PII] and today's date is your reference number. Is there anything else that I can assist you with?
[CUSTOMER][NEGATIVE] No, nothing thank you so much bye for now.
[AGENT][POSITIVE] Thank you again, [PII], for calling APL. Have a great day. Mm bye.
[CUSTOMER][NEUTRAL] Alright