AccountId: 011433970860
ContactId: 0bfc6495-b9c4-4657-be73-3b6b9b957c74
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 235750 ms
Total Talk Time (AGENT): 81457 ms
Total Talk Time (CUSTOMER): 113154 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/10/0bfc6495-b9c4-4657-be73-3b6b9b957c74_20250310T18:49_UTC.wav
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[AGENT][POSITIVE] Thank you for calling American Public Life. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, I'm calling from Sor office. I'm checking for the claim status.
[AGENT][NEUTRAL] OK, can I get your name again, please?
[CUSTOMER][NEUTRAL] Yeah, [PII] and the last initial is [PII]. Can you please spell your name?
[AGENT][NEUTRAL] Can I get a callback number, please?
[CUSTOMER][NEUTRAL] Yeah, it is [PII] at direct line. Can you please spell your name?
[AGENT][NEUTRAL] [PII] And could I get the policy number?
[CUSTOMER][NEUTRAL] Yes, just a moment. Uh, before that, what is your last initial?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK. The member ID number is 01708214 [PII].
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] The first name is [PII] and the last name is, it's [PII] and date of birth is [PII].
[AGENT][NEUTRAL] Thank you for that and you said that is what is the date of service?
[CUSTOMER][NEUTRAL] It's [PII]. And the total charges, it is uh $328 even. Uh that bill amount is split into two bill amount. The first one is $280 and the second one is $48.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] OK, I showed both claims received on [PII]. Both were denied on [PII]. Uh, this policy does not cover the services rendered in the physician's office. Is there anything else I can help you with?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, can you please tell me that? What was the denied reason again?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Oh, may, may I know that what was the delayed reason?
[AGENT][NEUTRAL] The policy does not cover services rendered in the physician's office.
[CUSTOMER][NEUTRAL] That's not covered under?
[CUSTOMER][NEUTRAL] Position of.
[CUSTOMER][NEUTRAL] OK. What was the claim number?
[AGENT][NEUTRAL] Uh, the first claim number for, um, the first claim number is 35,690.
[AGENT][NEUTRAL] I'm sorry, 356-590-8.
[CUSTOMER][NEUTRAL] OK. What was the second claim number for the $48?
[AGENT][NEUTRAL] $48 claim is 356-591-1.
[CUSTOMER][NEUTRAL] OK, got it. Uh, both the claim was the policy does not cover under physician uh office plan of office under the plan, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, got it. It is not good by the Poly play the office and the plan, got it.
[CUSTOMER][NEUTRAL] And can you please provide me the copy of the fax?
[AGENT][NEUTRAL] What is the fax number?
[CUSTOMER][NEUTRAL] That's [PII]. Please attention to my name, [PII].
[AGENT][NEUTRAL] Could you repeat the uh.
[AGENT][NEUTRAL] The number again please.
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][POSITIVE] OK. I will get these uh sent over in the next, you should receive them in the next 5 minutes. Is there anything else I can help you with?
[CUSTOMER][NEUTRAL] No, before that, can I get a reference number?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Can I get a reference number? Call reference number.
[AGENT][NEUTRAL] Reference number OK to reference our call you will use my name and today's date.
[CUSTOMER][POSITIVE] OK. Thanks for giving the required information. Take care. Bye-bye.
[AGENT][POSITIVE] You're welcome you have a wonderful day. Thank you for calling APL bye bye.
[CUSTOMER][NEUTRAL] Me.