AccountId: 011433970860
ContactId: 07bcb2ae-9c73-48ee-8b3d-55b34ebae0aa
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 235779 ms
Total Talk Time (AGENT): 66812 ms
Total Talk Time (CUSTOMER): 43722 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/17/07bcb2ae-9c73-48ee-8b3d-55b34ebae0aa_20250617T19:03_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, I'm calling from a provider's office. I just had a question about a claim.
[AGENT][NEUTRAL] OK, I can help you with claim status. Um, who am I speaking with?
[CUSTOMER][NEUTRAL] My name's [PII].
[AGENT][POSITIVE] And a good callback number in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And what's the policy number?
[CUSTOMER][NEUTRAL] It's 01716855.
[AGENT][NEUTRAL] Let me look that up real quick.
[AGENT][NEUTRAL] Can I get you to verify their name and date of birth for me, please?
[CUSTOMER][NEUTRAL] [PII], date of birth, [PII].
[AGENT][NEUTRAL] And do you have the claim number or the date of service?
[CUSTOMER][NEUTRAL] The date of service is [PII].
[AGENT][NEUTRAL] OK, and the uh provider name or the hospital name?
[CUSTOMER][NEUTRAL] Balance women's health.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And do you need the claim number?
[CUSTOMER][NEUTRAL] Um, no, it was just show being denied the service is not covered when performed in a doctor's office or clinic, and I'm trying to get further information on that.
[AGENT][NEUTRAL] OK, I do see that. So let me pull up his policy and let's look at that.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, give me just one moment while I look for it.
[AGENT][NEUTRAL] And was it a, um, was it a surgery?
[CUSTOMER][NEUTRAL] Uh, no, it was a therapy office visit, like mental health psychotherapy.
[AGENT][NEUTRAL] OK, let me look.
[AGENT][NEUTRAL] It looks like for this policy, it says uh it has an outpatient treatment for mental or emotional disorder in a hospital outpatient facility.
[CUSTOMER][NEUTRAL] OK, so it has to be a hospital.
[AGENT][NEUTRAL] Right. It's not like I'm, I'm assuming you're talking about like uh uh the uh the physical therapy at the, uh the therapist office, that's not covered.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, OK.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] And could I get a reference number?
[AGENT][NEUTRAL] We don't have call reference numbers, but you can use my name and last initial in today's date, so it's [PII] and then today's date.
[CUSTOMER][POSITIVE] OK, great. OK, well thank you so much for your help.
[AGENT][POSITIVE] Great, thank you for calling APL and have a great day.
[CUSTOMER][NEUTRAL] You