AccountId: 011433970860
ContactId: 0862c4fc-edbc-4083-b166-fe2d7881ae36
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 453510 ms
Total Talk Time (AGENT): 116831 ms
Total Talk Time (CUSTOMER): 119164 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/03/0862c4fc-edbc-4083-b166-fe2d7881ae36_20250103T19:36_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, yes, [PII], my name is [PII], and I'm calling to check claim status.
[AGENT][NEUTRAL] I'm sure [PII], I can assist you with claim status. Um first I'll need a good callback number just in case we're disconnected.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. Now I need the policy number, please.
[CUSTOMER][NEUTRAL] Policy number here would be um
[CUSTOMER][NEUTRAL] 0154852
[AGENT][NEUTRAL] OK. Please repeat that number.
[CUSTOMER][NEUTRAL] It is 015.
[CUSTOMER][NEUTRAL] 4852.
[AGENT][NEUTRAL] OK, I apologize. No one's coming up under that number. Um, do you have the Social Security number or I can look them up by name and date of birth?
[CUSTOMER][NEUTRAL] OK, we'll look up my name because I don't have their social.
[AGENT][NEUTRAL] OK. What's the last name?
[CUSTOMER][NEUTRAL] Patient's last name is.
[CUSTOMER][NEUTRAL] [PII], wait.
[CUSTOMER][NEUTRAL] Wait, wait, wait. Patient's last name is [PII], [PII]
[AGENT][NEUTRAL] And the first name, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, please verify his date of birth.
[CUSTOMER][NEUTRAL] Date of birth for this number here would be.
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][NEUTRAL] OK. Thank you. I found him in our system. Would you like his policy number?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, his policy number is 02485.
[AGENT][NEUTRAL] 38
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And you're calling to check the status of the claim. Um, what's the date of service and bill charges?
[CUSTOMER][NEUTRAL] Yes, claim status here, um, data service is 12-3-2024 for $300.
[AGENT][NEUTRAL] OK, I'm not showing a claim on file with that date of service.
[CUSTOMER][NEUTRAL] Is there a fax number?
[AGENT][NEUTRAL] Um, yes, ma'am. The clients can be faxed to [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII] and please attention the claims department.
[CUSTOMER][NEUTRAL] And your name?
[AGENT][NEUTRAL] My name is [PII]. Um, it's spelled [PII] and my last initial is [PII].
[CUSTOMER][NEUTRAL] Reference number?
[AGENT][NEUTRAL] It will be my name in today's date.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Is there anything else that I can assist you with?
[CUSTOMER][NEUTRAL] Yes, ma'am. I do have one other one.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I'm ready for the policy number.
[AGENT][NEUTRAL] Or is this another claim?
[CUSTOMER][NEUTRAL] I have the policy.
[AGENT][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Yes ma'am, it's a it's a different number, yes ma'am.
[AGENT][POSITIVE] OK, I'm ready.
[CUSTOMER][NEUTRAL] OK, I have that.
[CUSTOMER][NEUTRAL] Just lost it. OK, here we go.
[CUSTOMER][NEUTRAL] Members's ID I have is.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Patient's name is.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII], I'm sorry, [PII], date of birth [PII].
[AGENT][NEUTRAL] OK. OK.
[AGENT][NEUTRAL] And the date of service and bill charges on the claim, please.
[CUSTOMER][NEUTRAL] Data service for this claim here would be um 1023-2024 and total bill is for.
[CUSTOMER][NEUTRAL] $347.
[AGENT][NEUTRAL] OK. Yes, ma'am. We did receive that claim. We received it on [PII].
[AGENT][NEUTRAL] And the claim processed.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, [PII].
[AGENT][NEUTRAL] And the claim denied because this policy expired on [PII].
[CUSTOMER][NEUTRAL] This term on July you said.
[AGENT][NEUTRAL] Mhm. [PII]. Yes, ma'am.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Oh wow. That's a long time ago. Is there a claim number?
[AGENT][NEUTRAL] Um, yes, the claim number is 3539931.
[CUSTOMER][POSITIVE] OK. Well, thank you so much, [PII].
[AGENT][NEUTRAL] OK. Is there anything else that I can assist you with?
[CUSTOMER][POSITIVE] That would be all. Thank you kindly.
[AGENT][POSITIVE] OK, I thank you again, [PII] for calling APL. You have a great weekend. Mm bye.
[CUSTOMER][POSITIVE] Thank you as well bye bye.
[AGENT][POSITIVE] Thanks.