AccountId: 011433970860
ContactId: 028033ce-a4b6-4dd6-88bd-b30b44af1e39
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 175800 ms
Total Talk Time (AGENT): 83851 ms
Total Talk Time (CUSTOMER): 67712 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/06/028033ce-a4b6-4dd6-88bd-b30b44af1e39_20250206T20:58_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII] calling from a provider's office and I have a question to see if a claim has been received, please.
[AGENT][POSITIVE] OK, I can definitely check and see if it's been received for you. And [PII], may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] Thank you for that. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] Yes, 02069892.
[AGENT][POSITIVE] Thank you. Hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Yes, this is for [PII], [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And may I have the date of service for the claim you like me to check on?
[CUSTOMER][NEUTRAL] Yes, it is from [PII] for $157.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEUTRAL] Mhm sure.
[AGENT][NEUTRAL] 157.
[AGENT][NEUTRAL] And can you verify the name of the provider's office on the claim?
[CUSTOMER][NEUTRAL] Yes, this is for Mercy Hospital Lincoln.
[AGENT][NEUTRAL] Here it is. OK. So I'm showing that the claim was received on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And that claim number is 352.
[AGENT][NEUTRAL] 963 1.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And on [PII], the claim was denied as office visits are not covered by the policy.
[CUSTOMER][NEUTRAL] OK, is there any way we could get a copy of that remit? We've never received it or I don't know if that remit, I mean, should have went out by now, I would think.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Sure. Um, I can fax you a copy of it. What's a good fax number for you?
[CUSTOMER][POSITIVE] That would be great. It is 573.
[CUSTOMER][NEUTRAL] 519.
[CUSTOMER][NEUTRAL] 5327.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEUTRAL] Mhm sure.
[AGENT][NEUTRAL] And should that be attention, [PII]?
[CUSTOMER][NEUTRAL] [PII], yes.
[AGENT][NEUTRAL] And that was [PII]?
[CUSTOMER][POSITIVE] That is correct, yes.
[AGENT][NEUTRAL] All right, well, I'll go ahead and send this over to you now. Was there anything else I can help you with today, [PII]?
[CUSTOMER][NEUTRAL] Uh, is there a reference number for our call, please?
[AGENT][NEUTRAL] So there's no call reference number, but you can use my name in today's date. Um, the first initial to my last name is [PII], and my first name is [PII]
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thanks for your help. I appreciate it.
[AGENT][POSITIVE] You're very welcome. Well thanks for calling APL. I hope you have a good day.
[CUSTOMER][POSITIVE] Uh huh bye bye thank you.
[AGENT][NEUTRAL] Bye bye.