AccountId: 011433970860
ContactId: 06b9af5e-80d6-48e5-977d-a688b2436ab7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 254270 ms
Total Talk Time (AGENT): 77911 ms
Total Talk Time (CUSTOMER): 122469 ms
Interruptions: 0
Overall Sentiment: AGENT=-0.2, CUSTOMER=1.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/14/06b9af5e-80d6-48e5-977d-a688b2436ab7_20250514T15:54_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII] and I'm calling from a medical provider's office, and I'm calling to see if you happen to have a medical claim, please?
[AGENT][NEUTRAL] OK. Do you have a phone number I can get in case we get disconnected, I can call you back?
[CUSTOMER][NEUTRAL] Sure. My number is [PII].
[AGENT][NEUTRAL] And do you have the policy number?
[CUSTOMER][NEUTRAL] The number I have is 01989442M as in Mary L as in Larry 8.
[AGENT][NEUTRAL] And what's the patient's name?
[CUSTOMER][NEUTRAL] Patient [PII]. His date of birth is [PII].
[AGENT][NEUTRAL] Thank you, [PII], and you want to claim status?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] OK, I can help you with that. What date of service was it for?
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] It's for [PII] and the bill amount was.
[CUSTOMER][NEUTRAL] $599.
[AGENT][NEUTRAL] OK, hold on one moment, please.
[CUSTOMER][NEUTRAL] Actually, you know what?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] I apologize. It was not, it was for a total of $865. I apologize.
[AGENT][NEUTRAL] That's OK.
[AGENT][NEGATIVE] OK, we did get that claim in and it was denied.
[AGENT][NEGATIVE] It was denied for office visits not covered and services done in a doctor's office is not covered, but this policy actually canceled 11 to 25 as well.
[CUSTOMER][NEUTRAL] Canceled 1125. OK.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK. Um, do you happen to have the explanation of benefits that you could send to me?
[AGENT][NEGATIVE] Yes, ma'am. It, it's not gonna say that it canceled 11 to 25. It's just gonna say that office visits aren't covered and services done in the doctor's office is not covered because it was probably processed before the policy actually canceled.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. Gotcha. That'll be suffice.
[AGENT][NEUTRAL] OK. What's your fax number?
[CUSTOMER][NEUTRAL] My fax is [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, I'll fax that to you. Is there anything else I can help you with?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Um, well, can I just ask you a question? This is my first time on the APL portal, and I was able to do a couple of things, which is awesome. It's an awesome site, but if I don't have a social, I can't do anything, can I?
[CUSTOMER][NEUTRAL] Like the last 4 of his social asked for.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] Then I'd have to call because I don't have the last 4. Well, that sucks.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][POSITIVE] OK. Well, I appreciate your help, [PII]. Thank you. And do you use a call reference number?
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] We do not have call reference numbers. You can use my name in today's date.
[CUSTOMER][POSITIVE] OK, perfect.
[CUSTOMER][POSITIVE] All right. Thank you so much for your time.
[AGENT][POSITIVE] Thank you, [PII], for calling APO. You have a good day.
[CUSTOMER][POSITIVE] Thanks. You too.
[AGENT][POSITIVE] Thank you. Bye bye.
[CUSTOMER][NEUTRAL] Mm bye.
[CUSTOMER][NEUTRAL] Uh huh bye.