AccountId: 011433970860
ContactId: 085782a6-778b-4ecf-8de2-6b2444cd3cd2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 317779 ms
Total Talk Time (AGENT): 111271 ms
Total Talk Time (CUSTOMER): 83860 ms
Interruptions: 1
Overall Sentiment: AGENT=0.6, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/23/085782a6-778b-4ecf-8de2-6b2444cd3cd2_20250423T15:05_UTC.wav
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[AGENT][NEUTRAL] APL, this is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, good morning. I'm calling to get claim information.
[AGENT][NEUTRAL] Sure, I could assist you with that. Can I have your name and a callback number and that policy number?
[CUSTOMER][NEUTRAL] Yes, my name is [PII], last initial [PII]. My call back is [PII], the direct line.
[CUSTOMER][NEUTRAL] And I have the policy number is D as in David, 433.
[CUSTOMER][NEUTRAL] 01675
[AGENT][NEUTRAL] I do apologize apologize, [PII], but that's not a policy number here at American Public Life. Do you have the member's social?
[CUSTOMER][NEUTRAL] Um, sorry, one second, um, just double check it. Mm.
[CUSTOMER][NEUTRAL] OK, I'm sorry. It's [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And what is this member's name?
[CUSTOMER][NEUTRAL] That is [PII].
[AGENT][NEUTRAL] Could you verify [PII]'s date of birth?
[CUSTOMER][NEUTRAL] Yes, I have that as [PII].
[AGENT][NEUTRAL] Thank you [PII], what is the date of service that you're calling to check the status of a claim for?
[CUSTOMER][NEUTRAL] Uh, the data service I have is [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] This is for medical, correct?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Could you provide me with a procedure code?
[CUSTOMER][NEUTRAL] Uh, one second, let me open the claim.
[CUSTOMER][NEUTRAL] There are 2 on the account. Uh, the first one is 55,700.
[AGENT][POSITIVE] Thank you. 972.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Actually this claim was submitted [PII]. It was processed [PII]. There was a payment of, no, that's not it.
[AGENT][NEUTRAL] Yeah, that is, this is it. There was a payment of $77.20 made on this claim. Would you like the check number?
[CUSTOMER][NEUTRAL] Uh, was there any denials on the claim? Or was it paid in full?
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] So this claim, it says that diagnostic benefits for MRI.
[AGENT][NEUTRAL] Cooscopy, colonoscopy or CT only cover diagnosis benefits. So the procedure called uh
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] 76872 was denied.
[CUSTOMER][NEUTRAL] OK, and I'm sorry, what did you say the denial was for that?
[AGENT][NEUTRAL] That um procedure is not covered under the policy.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK. Uh, and you said it paid $77.20. OK. Uh, yes. May I have that, uh, check number?
[AGENT][NEUTRAL] The check number?
[AGENT][NEUTRAL] It's 2030178. It's 2030178.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. And was that a bulk or a single payment?
[AGENT][NEUTRAL] Single payment, single payment and it was cleared [PII].
[CUSTOMER][NEUTRAL] And I'm sorry, when did you say that the claim is processed?
[AGENT][NEUTRAL] The claim was received [PII]. It was processed [PII]. The check was sent out on [PII]. It was cashed [PII].
[CUSTOMER][POSITIVE] OK thank you.
[CUSTOMER][NEUTRAL] I think that was all that I needed for today. Is there a reference number for the call?
[AGENT][NEUTRAL] Is there anything else that I can assist you with today?
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] We don't provide reference numbers, however, you can use my name in today's date as a reference. Would you like for me to provide you with the spelling of my name?
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] [PII] and today's date.
[CUSTOMER][POSITIVE] OK. Thank you so much for your help. I hope you have a great rest of your day.
[AGENT][POSITIVE] You're welcome, [PII]. Thanks for calling APL. You have a great one as well. Goodbye.
[CUSTOMER][POSITIVE] Thank you. Bye-bye.