AccountId: 011433970860
ContactId: 082a6fe6-f066-4ad7-8ca8-46a64a0a6e47
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 289940 ms
Total Talk Time (AGENT): 126346 ms
Total Talk Time (CUSTOMER): 96169 ms
Interruptions: 2
Overall Sentiment: AGENT=0.6, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/13/082a6fe6-f066-4ad7-8ca8-46a64a0a6e47_20250313T22:27_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yeah, hi, my name is [PII]. I'm calling from the doctor's office. I need to verify claim status.
[AGENT][NEUTRAL] Sure, I can check on a claim for you. Uh, [PII], can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]. It was a direct line.
[AGENT][NEUTRAL] Alright, thank you. And then do you have the policy number?
[CUSTOMER][NEUTRAL] Yes, the ID number is 241069.
[AGENT][NEUTRAL] I'm sorry, that was 241-069?
[CUSTOMER][NEUTRAL] And that was
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, that's a bit too short to be one of our policy numbers, [PII], um, do you maybe have their, uh, social I could search for them that way.
[CUSTOMER][NEUTRAL] Just
[CUSTOMER][NEUTRAL] So um.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] OK. Yes, the social is [PII].
[AGENT][NEUTRAL] OK thank you one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And what was the name and date of birth for the member?
[CUSTOMER][NEUTRAL] And date of birth for the number. They will Lilo. The birth date is uh [PII].
[AGENT][NEUTRAL] OK, thank you for verifying that. And was this for uh medical or dental?
[CUSTOMER][NEUTRAL] Medical
[AGENT][NEUTRAL] Medical, OK, thank you. um I've got that correct policy number I can give that to you whenever you're ready.
[CUSTOMER][POSITIVE] Yes, I'm ready.
[AGENT][NEUTRAL] OK, that is, excuse me 02.
[AGENT][NEUTRAL] 461069.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then what was the date of service for this claim?
[CUSTOMER][NEUTRAL] [PII]. The bill amount is $414 even.
[AGENT][NEUTRAL] That was [PII]?
[CUSTOMER][NEUTRAL] All right?
[AGENT][NEUTRAL] OK, so this policy did terminate um [PII], but I can still check to see if we received that claim if you'd like.
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][POSITIVE] OK, thank you one moment.
[CUSTOMER][NEUTRAL] Welcome.
[AGENT][NEUTRAL] OK, so we did receive this claim, of course we were unable to pay a benefit as the services were rendered after coverage was terminated.
[CUSTOMER][NEUTRAL] Mhm. Can you please confirm me that when uh claim has been received and what was the exact status on this claim?
[AGENT][NEUTRAL] Sure, so this claim was received [PII], and it was processed [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, do you need the claim number?
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] That is 351-557-1.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] What about the status of the claim?
[AGENT][NEGATIVE] It has been denied as the services were rendered after coverage was terminated.
[CUSTOMER][NEUTRAL] OK. But the pretermination uh was on [PII], right?
[AGENT][NEUTRAL] [PII], yes.
[CUSTOMER][NEUTRAL] OK, uh, but, uh, we didn't get the, uh, delayed you from your end. Is there any option to fax me or?
[AGENT][NEUTRAL] Sure.
[AGENT][POSITIVE] I can send that to you absolutely um what was that fax number for you?
[CUSTOMER][NEUTRAL] [PII]. With attention, my name is [PII].
[AGENT][NEUTRAL] OK, I'm gonna read that back to you, make sure I heard that correctly. That was [PII].
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] You
[CUSTOMER][POSITIVE] It's all right.
[AGENT][POSITIVE] OK, I will get that sent to you. You should get it here within 10 to 15 minutes. Uh, was there anything else I could help you with?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, before going to close the call, can you please spell out your name and any call reference number on this call?
[AGENT][NEUTRAL] Reference number would just be my first name, last initial, and today's date. Uh my name is spelled [PII]
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you so much, and have a great day.
[AGENT][POSITIVE] Of course, thanks for calling APL you too bye bye.
[CUSTOMER][NEUTRAL] Of course.
[CUSTOMER][NEUTRAL] Bye-bye.