AccountId: 011433970860
ContactId: ff651c0e-c89c-4983-9d10-74e236f05c39
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 291380 ms
Total Talk Time (AGENT): 115128 ms
Total Talk Time (CUSTOMER): 89579 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/10/ff651c0e-c89c-4983-9d10-74e236f05c39_20250610T13:47_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from MSC physicians to check on the claim status.
[AGENT][NEUTRAL] OK, I can verify claim status for you. And your name is again?
[CUSTOMER][NEUTRAL] Name of my spelling is [PII], and my last name initial is [PII].
[AGENT][NEUTRAL] OK, [PII], what is the policy number, please?
[CUSTOMER][NEUTRAL] Policy number is
[CUSTOMER][NEUTRAL] 022
[CUSTOMER][NEUTRAL] 60487. And if you don't mind, could you repeat your name? Sorry, I missed your name.
[AGENT][NEUTRAL] Sure, it's [PII], last initial [PII].
[AGENT][NEUTRAL] And do you have a callback number in case the call drops? Mhm.
[CUSTOMER][POSITIVE] Thank you so much for the information.
[CUSTOMER][NEUTRAL] Sure, callback number is [PII] direct line.
[AGENT][NEUTRAL] OK, and verify the patient's name, date of birth.
[CUSTOMER][NEUTRAL] Patient name is [PII] and date of birth.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you and what was the date of service and amount of the charge?
[CUSTOMER][NEUTRAL] Data services uh [PII].
[CUSTOMER][NEUTRAL] For the bill amount of $202 even.
[AGENT][NEUTRAL] And the balance after primary?
[CUSTOMER][NEUTRAL] $30 even.
[AGENT][NEUTRAL] OK, one moment. And while I'm looking up claim information, just to let you know, we do have an online service center where providers can check claim status as well as print out the EOB. That site is at [PII].
[AGENT][NEUTRAL] And the name of the provider's office?
[CUSTOMER][NEUTRAL] So it's a
[CUSTOMER][NEUTRAL] So we need to register for that portal or it's an open portal?
[AGENT][NEUTRAL] It's open. Like I said, it's a place where providers can verify claim status as well as print out the EOB.
[AGENT][NEUTRAL] And the name of the provider's office?
[CUSTOMER][NEUTRAL] If you don't mind, could you repeat me the portal name again.
[AGENT][POSITIVE] Sure, Secured SE.
[CUSTOMER][NEUTRAL] Provider's office name is [PII].
[AGENT][NEUTRAL] OK, it's [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And I show this claim process as office, OK, and I show this claim process says office visits are not covered per the policy.
[CUSTOMER][POSITIVE] Thank you so much for the information.
[CUSTOMER][NEUTRAL] So it's denied, right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] So is it as for the patient's plan?
[AGENT][NEGATIVE] Per the patient's policy, it is not covered.
[CUSTOMER][NEUTRAL] Can have the patient's plan type?
[AGENT][NEUTRAL] As a secondary supplemental policy that covers services performed in an outpatient facility or inpatient in a hospital.
[CUSTOMER][NEUTRAL] So, obviously, is not covered as for the patient's plan, right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Can I have the claim received it and processed it.
[AGENT][NEUTRAL] Claim received [PII] processed on [PII].
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Can I have the claim number?
[AGENT][NEUTRAL] 3507541.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Can you send a copy of the UV to our fax number?
[AGENT][NEUTRAL] What is the fax number?
[CUSTOMER][NEUTRAL] Fax number is [PII].
[CUSTOMER][NEUTRAL] 225
[CUSTOMER][NEUTRAL] 2174. Attention, my name, [PII]
[AGENT][NEUTRAL] OK, and you said it's [PII] and is there anything else I can assist you with today?
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] That's right.
[CUSTOMER][NEUTRAL] No, that's all for today. Can I have the reference number for this call?
[AGENT][NEUTRAL] Uh, you may use my name at today's date.
[CUSTOMER][NEUTRAL] Basically going on but yeah I'm looking up.
[CUSTOMER][POSITIVE] Thank you so much for your patiencely assisting me, [PII]. Have a great rest of your day. Stay there. Take care. Bye-bye.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] Mhm. Thank you for calling APL. Bye.