AccountId: 011433970860
ContactId: 08cec8f2-dd7f-4702-8445-dbe83425f446
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 161800 ms
Total Talk Time (AGENT): 57868 ms
Total Talk Time (CUSTOMER): 51880 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/18/08cec8f2-dd7f-4702-8445-dbe83425f446_20250618T19:57_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi sir, my name is [PII]. I'm calling in reference to a claim.
[AGENT][POSITIVE] Alright, I'm happy to check on the claim. Do we have a claim number, policy number?
[CUSTOMER][NEUTRAL] I have a claim number.
[AGENT][NEUTRAL] OK, what's that?
[CUSTOMER][NEUTRAL] 202-505-270757.
[AGENT][NEUTRAL] OK, yeah, that's way too long to be one of our claim numbers. What's the policy number? Do you have that?
[CUSTOMER][NEUTRAL] Um, yes, the policy number I have is 02294497.
[AGENT][NEUTRAL] All right. And then if I can get the patient's name and date of birth.
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] What is the data service?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] All right. And then do we have a bill amount?
[CUSTOMER][NEUTRAL] Yes, it's $10,681.96.
[AGENT][NEUTRAL] OK.
[AGENT][NEGATIVE] So it looks like we did get the claim. It's showing it was denied. Policy does not provide any benefits for the treatment of alcohol or drug abuse.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] So, um, is it?
[CUSTOMER][NEUTRAL] So processes it's the patient's responsibility to members responsibility for total charges is there any discounts or and
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah, it's a non-covered benefit. It was a limited benefit plan that they have with us, so it, it was either one of those, it's gonna pay or not, yeah.
[CUSTOMER][NEUTRAL] And it's like
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh right, OK, let me, alright, can I have a call reference?
[AGENT][NEUTRAL] Absolutely. Call references my name with today's date. My name again is [PII], that's [PII] and then last initial [PII] and today's date.
[CUSTOMER][POSITIVE] OK thanks sir have a great day.
[AGENT][POSITIVE] You're welcome you too bye bye.