AccountId: 011433970860
ContactId: 07842564-91dc-4025-9fc4-8b4663706a0b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 183320 ms
Total Talk Time (AGENT): 86155 ms
Total Talk Time (CUSTOMER): 55687 ms
Interruptions: 0
Overall Sentiment: AGENT=1.6, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/13/07842564-91dc-4025-9fc4-8b4663706a0b_20250313T19:09_UTC.wav
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[AGENT][NEUTRAL] Afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes. Hi, yes, I'm calling in reference to a claim that I need the status of, please.
[AGENT][NEUTRAL] OK, are you calling from the provider's office?
[CUSTOMER][NEUTRAL] Yes, Prisma Health.
[AGENT][NEUTRAL] OK, and you're needing to take claim status? OK, [PII], and you said you're wanting claim status for one patient?
[CUSTOMER][NEUTRAL] And my name is [PII].
[CUSTOMER][NEUTRAL] Yes, I
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Yes ma'am, I can help you with that. And [PII], what is your callback number?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And the member's policy number please, [PII]?
[CUSTOMER][NEUTRAL] It is 002137806.
[AGENT][NEUTRAL] OK, thank you. One moment while I get the information pulled up for the member, please.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and any information that I do provide would be a verification of benefits and not a guarantee of payment. What is her date of birth?
[CUSTOMER][NEUTRAL] Her date of birth is [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And what is the date of service [PII] and total build amount please?
[CUSTOMER][NEUTRAL] [PII], the total bill amount was $315.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] And they were just waiting for $60 if.
[CUSTOMER][NEUTRAL] It's applicable.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so this claim was received [PII], um, the claim number is 356-0790.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And this claim was denied [PII], and the reason for the denial is that office visits are not covered under the supplemental policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Covered. OK. Can I have um your name and a reference number?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] My name again is [PII] and my name and today's date would be your call reference number and [PII], if you need a copy of this explanation of benefits, we do have a portal that you should be able to print that from and our portal website is located at [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Yes, I have that. OK, thank you so much.
[AGENT][POSITIVE] OK. Well, you are very welcome. And again, is there anything else I can help you with?
[CUSTOMER][POSITIVE] No, ma'am. You have a wonderful day.
[AGENT][POSITIVE] Well, I hope you do too, and thank you again for calling APL.
[CUSTOMER][NEUTRAL] All right, bye-bye.
[AGENT][NEUTRAL] Bye