AccountId: 011433970860
ContactId: 0b56e837-fc2b-4fb9-9a50-6a0d33fa7a1f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 321929 ms
Total Talk Time (AGENT): 87868 ms
Total Talk Time (CUSTOMER): 95351 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/03/0b56e837-fc2b-4fb9-9a50-6a0d33fa7a1f_20250303T19:17_UTC.wav
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[AGENT][NEUTRAL] Call APO this [PII]. I assist you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII] calling from Nationwide Medical Sciencespris office, and I'm looking for the claims.
[AGENT][NEUTRAL] Sure, I can assist you with that. You said your name was [PII]?
[CUSTOMER][NEUTRAL] Yeah, [PII], [PII].
[AGENT][NEUTRAL] Yeah, can I have a callback number for you and that policy number?
[CUSTOMER][NEUTRAL] Callback number [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And the policy number of the member that you're inquiring on benefits for today?
[CUSTOMER][NEUTRAL] Policy number 1129521.
[AGENT][NEUTRAL] What is this member's name and date of birth, [PII]?
[CUSTOMER][NEUTRAL] Member's name is [PII].
[CUSTOMER][NEUTRAL] [PII]. Last name [PII].
[CUSTOMER][NEUTRAL] Date of birth of the patient is [PII].
[AGENT][NEUTRAL] Thank you, and what is the date of service that you're inquiring about today?
[CUSTOMER][NEUTRAL] Uh, actually I have multiple data services for this patient for state of service is.
[AGENT][NEUTRAL] So what is the first one?
[CUSTOMER][NEUTRAL] First one is [PII].
[CUSTOMER][NEUTRAL] Bill on $252.
[AGENT][NEUTRAL] The bill amount was how much?
[CUSTOMER][NEUTRAL] $252.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] 7102
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] 714.
[AGENT][NEUTRAL] 7101, so we received this claim [PII]. It was processed [PII].
[CUSTOMER][NEUTRAL] Please.
[AGENT][NEUTRAL] There was no payment made on this claim because the services provided is not covered under the policy.
[CUSTOMER][NEUTRAL] As members.
[AGENT][NEUTRAL] The member's policy does not cover durable medical equipment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, what is the type of patients plan?
[AGENT][NEGATIVE] It does not cover them doable medical equipment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Just hold on, ma'am.
[CUSTOMER][NEUTRAL] Uh, what is it, uh.
[CUSTOMER][NEUTRAL] Can you please provide me the plan type of the patient?
[AGENT][NEUTRAL] This policy is a gap insurance that assists with the deductible, co-pay and co-insurance for services that's covered under the policy, and durable medical equipment is not a cover service. Is there anything else that you would like for me to assist you with in regards to this claim?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Can you please provide me the claim number?
[AGENT][NEUTRAL] The claim number is 356-7101. That's 3567101.
[CUSTOMER][NEUTRAL] OK, and what will be the product number for this patient?
[AGENT][NEUTRAL] What will be the, who, sir?
[CUSTOMER][NEUTRAL] Call the reference number for this patient.
[AGENT][NEUTRAL] We don't provide reference numbers unfortunately [PII], however, you can use my name in today's date as a reference.
[CUSTOMER][NEUTRAL] Uh, can you please provide me your name?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] First Nation.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, so thanks so much, ma'am. Thanks for the information and have a nice day bye bye for now.
[AGENT][POSITIVE] Thanks for calling APL. Have a great day. Goodbye.