AccountId: 011433970860
ContactId: fbcf68c3-3935-427f-8c62-cb1882ce17f0
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 291549 ms
Total Talk Time (AGENT): 78976 ms
Total Talk Time (CUSTOMER): 99758 ms
Interruptions: 1
Overall Sentiment: AGENT=1.4, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/25/fbcf68c3-3935-427f-8c62-cb1882ce17f0_20250325T16:56_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey, hi, sir. Uh, this is [PII] from the doctor's office to check on the claim status.
[AGENT][POSITIVE] All right. I'm happy to check on a claim status for you today, [PII]. Can I get the patient's policy number?
[CUSTOMER][NEUTRAL] The patient's policy number is going to be 1275591.
[AGENT][POSITIVE] Thank you. And do you have a good callback number?
[CUSTOMER][NEUTRAL] I'm.
[CUSTOMER][NEUTRAL] [PII], no extension direct line.
[AGENT][NEUTRAL] Thank you. Patient's name and date of birth?
[CUSTOMER][NEUTRAL] What
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Loest the date of birth is [PII].
[AGENT][NEUTRAL] Thank you for that and then what's the date of service?
[CUSTOMER][NEUTRAL] The rate of service for the climbers.
[CUSTOMER][NEUTRAL] 318 2024 with the total bill amount is $407 even.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] If something.
[AGENT][NEUTRAL] Right, so it looks like we did receive a claim uh for the state of service. claim was received on [PII].
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] 3.
[AGENT][NEUTRAL] The claim was denied on [PII]. Office visits are not covered under the member's policy.
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Like.
[CUSTOMER][NEUTRAL] What is the patient's plan name?
[AGENT][NEUTRAL] Uh, we are the secondary insurance. This is a Medlink plan.
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] Medin.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Just meddling plan, right?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] American public life patient meddling plan, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] And why it was why the offices are not covered under the patient's plan.
[AGENT][NEUTRAL] Office visits are not covered under the patient's plan, correct.
[CUSTOMER][POSITIVE] And what we can do for this one.
[AGENT][NEUTRAL] In regards to
[CUSTOMER][NEUTRAL] Can we bring this to the patient?
[AGENT][NEUTRAL] We're not able to advise on patient responsibility. That's up to the facility or provider if they want to build the patient.
[CUSTOMER][NEUTRAL] No, if the patient, if the plan if the service was not covered under the patient's plan, can we build this to the patient?
[AGENT][NEUTRAL] It
[AGENT][NEUTRAL] I can't advise on that. That's up to the facility or provider.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I got it. Can I get the claim number and the call reference number?
[AGENT][NEUTRAL] 3456156.
[CUSTOMER][NEUTRAL] And.
[AGENT][NEUTRAL] Call reference is my name with my last initial than today's date. My name again is [PII], that's [PII] Last initial is [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] I got it straight around. That's it for the day. Have great day be said bye for now.
[AGENT][NEUTRAL] You too. Bye-bye.
[CUSTOMER][NEUTRAL] Oh.