AccountId: 011433970860
ContactId: ff397383-944e-43db-92f5-b6d1e0b215ab
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 217990 ms
Total Talk Time (AGENT): 72532 ms
Total Talk Time (CUSTOMER): 73318 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/04/ff397383-944e-43db-92f5-b6d1e0b215ab_20250204T13:24_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yeah, my name is [PII] calling from provider office looking for claim status.
[AGENT][NEUTRAL] I'm sure, [PII] I can assist you with claim status. Um, first, could I get a good callback number just in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes, [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. Now, I need the member's policy number, please.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] 015.
[CUSTOMER][NEUTRAL] 51662.
[AGENT][NEUTRAL] Thank you. Please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] My date of birth is
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] And the date of service and bill charges on the claim, please.
[CUSTOMER][NEUTRAL] Date of service is [PII] with the total amount of
[CUSTOMER][NEUTRAL] Just a second.
[CUSTOMER][NEUTRAL] OK, total bill amount is $260 even.
[AGENT][NEUTRAL] OK, thank you. We did receive that claim on [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The claim processed on [PII].
[AGENT][NEUTRAL] The claim number is 355-0311.
[AGENT][NEUTRAL] And the claim denied because office visits are not covered under the member's policy.
[CUSTOMER][NEUTRAL] OK, not covered.
[CUSTOMER][NEUTRAL] And what's the patient's plan name?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Meddling plan, right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, just give me a second.
[CUSTOMER][NEUTRAL] OK, but as a primary, uh, Blue Cross Blue Shield pay this one, so.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Uh, there's a different uh plans of primary and secondary.
[AGENT][POSITIVE] Um, yes, we're the set.
[CUSTOMER][NEUTRAL] Because it's covered by the primary.
[AGENT][NEUTRAL] Right. We're the secondary policy and it's not covered under this policy, so that's why we denied it. Is there anything else that I can assist you with?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Just give me a second. Let me find uh any other claims for today.
[AGENT][NEUTRAL] OK. Sure.
[CUSTOMER][NEUTRAL] Um just a second, American life.
[CUSTOMER][NEUTRAL] OK, no more questions for today. Can I have a reference number?
[AGENT][NEUTRAL] Yes, for the reference number, you can use my name and today's date. My name is [PII]. It's spelled [PII] My last initial is [PII], and today's date.
[CUSTOMER][POSITIVE] OK. Thank you so much, [PII]. Bye-bye.
[AGENT][POSITIVE] Yeah, thank you, [PII] for calling APL. You have a great day. Mm bye.
[CUSTOMER][POSITIVE] a great