AccountId: 011433970860
ContactId: 0d1535bf-d193-4045-a666-984fc824e5bc
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 182520 ms
Total Talk Time (AGENT): 77493 ms
Total Talk Time (CUSTOMER): 50645 ms
Interruptions: 0
Overall Sentiment: AGENT=1.7, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/08/0d1535bf-d193-4045-a666-984fc824e5bc_20250408T13:08_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], I'm calling for claim status.
[AGENT][POSITIVE] OK, I'll be more than happy to help you with the claim status. May I have your name and a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure, it's [PII] and contact is [PII].
[AGENT][NEUTRAL] Thank you for that. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] I have 0233313M.
[CUSTOMER][NEUTRAL] Sorry, 138 ML 8.
[AGENT][NEUTRAL] Thank you for that. And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And may I have the date of service and the total bills for the claim?
[CUSTOMER][NEUTRAL] [PII] for $77.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And can you verify the name of the provider's office on the claim?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, here we go.
[AGENT][NEUTRAL] Hold on one moment.
[AGENT][NEUTRAL] So I'm showing that the claim was received on [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The claim number is 352-447-3.
[AGENT][NEUTRAL] And on [PII], the claim was denied.
[AGENT][NEUTRAL] Covered outpatient services, well, I can read the whole, uh,
[AGENT][NEGATIVE] Denial reason to you, but basically independent lives are not covered by this policy. It wasn't a covered place of service.
[CUSTOMER][NEUTRAL] OK, got it. Independent labs not covered, and this would be members responsibility?
[AGENT][NEUTRAL] So we don't determine patient responsibility because we're not the major medical.
[CUSTOMER][NEUTRAL] OK, got it. Independent labs not covered. OK, can I get a reference number please?
[AGENT][NEUTRAL] Sure, so there's no call reference number, but you can use my name in today's date. The first initial to my last name is [PII], and my first name is [PII]
[CUSTOMER][POSITIVE] Got it. OK, thank you, [PII].
[AGENT][POSITIVE] You're very welcome, [PII]. Was there anything else I could assist you with today?
[CUSTOMER][NEUTRAL] No, that's it.
[AGENT][POSITIVE] Alright well thank you so much for calling APL. I hope you have a great day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thank you