AccountId: 011433970860
ContactId: fd723227-df6a-4dec-899d-956f69ab9456
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 218960 ms
Total Talk Time (AGENT): 51910 ms
Total Talk Time (CUSTOMER): 92979 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/30/fd723227-df6a-4dec-899d-956f69ab9456_20250530T19:13_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hello, my name is [PII]. I'm calling from provider's office. Today I call you regarding claim dance. Could you help me with that?
[AGENT][POSITIVE] Happy to check on a claim. Can I get your first name again, please?
[CUSTOMER][NEUTRAL] Yes, sure. My name is [PII]. So it's spelled as [PII] Last name initial [PII]. Can you spell it out your name for me?
[AGENT][NEUTRAL] My name is [PII].
[CUSTOMER][NEUTRAL] OK, thank you. And before we proceed, we will let you know that the call has been recorded for quality and training purposes. So would you like to continue with us, sir?
[AGENT][NEUTRAL] That's fine. Can I get the patient's policy number, please?
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Yeah, sure. It's going to be 02320074.
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] Patient's name, [PII]. Date of birth, [PII]. And the service is going to be [PII] and total bill amount is $340.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][POSITIVE] Sure. Take your time.
[AGENT][NEUTRAL] All right, thank you for your patience. So this claim was received on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The claim was denied on [PII].
[AGENT][NEUTRAL] Office visits are not covered under the member's policy.
[CUSTOMER][NEUTRAL] Office visit?
[CUSTOMER][NEUTRAL] Not covered under the member policy, OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And this plan is covered co-pay and coinsurance?
[AGENT][NEUTRAL] It is their secondary, it covers deductible, co-pay, and co-insurance, yes.
[CUSTOMER][NEUTRAL] OK. So,
[CUSTOMER][NEUTRAL] 25, it's a co-pay.
[CUSTOMER][NEGATIVE] So why did this, uh, this remaining amount is not paid? Because it's an office visit?
[AGENT][NEUTRAL] Because, right, because the plan doesn't cover the office visit fee.
[CUSTOMER][NEUTRAL] OK, OK, got it.
[CUSTOMER][NEUTRAL] OK, sir. uh, thank you so much. May I have the call reference number for this claim?
[AGENT][NEUTRAL] Call reference is my name with today's date. My name again is [PII] and then today's date.
[CUSTOMER][POSITIVE] OK. Thank you so much for helping me today. And yes, that's it for today. Thank you so much for helping me, [PII].
[AGENT][POSITIVE] You're welcome. Bye-bye.
[CUSTOMER][NEUTRAL] Bye-bye.