AccountId: 011433970860
ContactId: 040dfac5-ed91-4c7b-8db2-cc63e4d82519
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 265799 ms
Total Talk Time (AGENT): 85266 ms
Total Talk Time (CUSTOMER): 121872 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/16/040dfac5-ed91-4c7b-8db2-cc63e4d82519_20250116T14:21_UTC.wav
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[AGENT][NEUTRAL] Calling APL, this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hey, [PII], this is [PII]. I'm calling from the office for checking on a claim, sorry, claim status.
[AGENT][NEUTRAL] OK, [PII], I can help you with claim status in case this call is disconnected, may I have your call back number?
[CUSTOMER][NEUTRAL] Sure. It's [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And may I have the patient's policy number, please?
[CUSTOMER][NEUTRAL] You will.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Policy number is 022118007.
[AGENT][NEUTRAL] Thank you, and it was 022118007?
[CUSTOMER][POSITIVE] Yeah, that's correct.
[AGENT][NEUTRAL] And may I have the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] Patient's uh name is [PII]. Date of birth, [PII].
[AGENT][NEUTRAL] Thank you. May I have the date of service and the bill amount?
[CUSTOMER][NEUTRAL] Data service [PII] and the bill amount is $260 even $260.
[AGENT][NEUTRAL] Thank you. So that's for [PII] data service for $260.
[CUSTOMER][POSITIVE] Yup, that's correct.
[AGENT][NEUTRAL] Show that claim was received on [PII]. It was processed on [PII].
[AGENT][NEUTRAL] And our records indicate that premium for this data service was not received, therefore benefits are not payable. Would you like the claim number?
[CUSTOMER][NEUTRAL] Uh, no, I already have that information. Uh, so for the same patient for another data service which was on [PII], was also denied, is this because of the same, uh, premium not paid, uh, reason?
[AGENT][NEUTRAL] What is the bill amount of that claim?
[CUSTOMER][NEUTRAL] Uh, so, it is also for $260 even 260.
[AGENT][NEUTRAL] OK, yes, I do show we process it on [PII] and it is for the same reason. I show this policy term [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Of [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] [PII]. May I know the uh enrolled and uh enrolled date of this insurance?
[AGENT][NEUTRAL] The effective date?
[CUSTOMER][POSITIVE] Yup, that's correct.
[AGENT][NEUTRAL] It was effective [PII].
[CUSTOMER][NEUTRAL] [PII] and was effective until [PII], correct?
[AGENT][NEUTRAL] Yes, and it turned [PII].
[CUSTOMER][NEUTRAL] Uh-huh. I still have one more, uh, claim for another patient. Will you, will you be able to check on that?
[AGENT][NEUTRAL] OK, what is the policy number?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Just give me a moment here.
[CUSTOMER][NEUTRAL] The policy number I have here is, uh, sorry, that was for another.
[CUSTOMER][NEUTRAL] Uh, insurance. Sorry for that.
[AGENT][NEUTRAL] OK, is there anything else I can assist you with today, [PII]?
[CUSTOMER][NEUTRAL] Uh, you can just help me with the call reference number.
[AGENT][NEUTRAL] I'm sorry, can you repeat that?
[CUSTOMER][NEUTRAL] Uh, you can help me with the call reference number. And also one more thing, do you see any other active insurance for this patient?
[AGENT][NEUTRAL] No, there's currently no active coverage.
[AGENT][NEUTRAL] And as far as the reference number, it would be just my name and today's date, and that's [PII] spelled [PII]
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Is there anything else I can assist you with today, [PII]?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh no, [PII], nothing else.
[AGENT][POSITIVE] OK, well thanks for calling APO you have a good day.
[CUSTOMER][POSITIVE] You too. Have a good day. Bye-bye. Take care.
[AGENT][POSITIVE] Thank you bye.