AccountId: 011433970860
ContactId: 0d8540b4-ea37-482e-a2b8-695916c4b314
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 324660 ms
Total Talk Time (AGENT): 139970 ms
Total Talk Time (CUSTOMER): 121399 ms
Interruptions: 0
Overall Sentiment: AGENT=2, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/29/0d8540b4-ea37-482e-a2b8-695916c4b314_20250429T18:44_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling. This is [PII]. How may I help you today?
[CUSTOMER][NEUTRAL] Yeah, hi, this is [PII]. I'm calling from Bram Healthcare Center. I want to know the status of the claim, so can you please help me with it?
[AGENT][POSITIVE] Yes ma'am, but I am so sorry. I did not catch your name.
[CUSTOMER][NEUTRAL] Yeah, my name is [PII].
[AGENT][POSITIVE] Alright the pick uh, go ahead and give me a good policy number.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yeah, the policy number is
[CUSTOMER][NEUTRAL] 022 038 37.
[AGENT][POSITIVE] Alright, to pick you up, thank you so much for that information. Now, while I'm pulling this up, go ahead and give me a good return telephone call number, please, ma'am.
[CUSTOMER][NEUTRAL] Yes. The callback number is [PII].
[AGENT][POSITIVE] All righty. [PII], thank you so much for all that information. Now, what's your patient's name and date of birth today, please, ma'am?
[CUSTOMER][NEUTRAL] Yes, the member, the patient name is [PII] and last name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] All right, [PII], thank you so much for all that information. Now, you did say that you were checking status of a claim. Is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes, ma'am. What's that date of service, please, ma'am?
[CUSTOMER][NEUTRAL] The date of service is [PII].
[AGENT][NEUTRAL] And your total bill.
[CUSTOMER][NEUTRAL] The total bill is $3730.18.
[AGENT][POSITIVE] Alright, [PII], thank you so much for that information. Give me just a moment, let me get that pulled up. Let's see.
[CUSTOMER][NEUTRAL] Yes. Could you please confirm me your name?
[AGENT][NEUTRAL] Yes, ma'am. My name is [PII]. That's [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] All right, the [PII] looks like we do have your claim in-house. Now, the, um, under this medical supplemental plan, they do not have benefits for durable medical equipment or supplies, so this claim was denied. It is not going to be covered.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. Could you please confirm me, it is not covered under the medical uh benefits plan, right?
[AGENT][NEGATIVE] Right, it is not a covered benefit here.
[CUSTOMER][POSITIVE] Benefit. OK, no worries. Thank you for that information. Could you please confirm me the claim number?
[AGENT][NEUTRAL] Yes, your claim number is 3.
[AGENT][NEUTRAL] 563 298.
[CUSTOMER][NEUTRAL] It is 363-298, correct?
[AGENT][NEUTRAL] 356.
[CUSTOMER][NEUTRAL] 35
[AGENT][NEUTRAL] 6
[CUSTOMER][NEUTRAL] Could you please again confirm me?
[AGENT][NEUTRAL] 329 8. Yes.
[AGENT][NEUTRAL] That claim number is 356.
[AGENT][NEUTRAL] 329
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] 3298, right?
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK. 3298. And this
[CUSTOMER][NEGATIVE] This is denied because of the member not have the patient the benefit plan, right? Not covered the benefit plan.
[AGENT][NEUTRAL] Right.
[AGENT][POSITIVE] That is correct, the Pia.
[CUSTOMER][NEUTRAL] not covered. OK. Thank you so much for that information. Could you please confirm me the, your call reference number and your last initial also?
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] We do not
[AGENT][NEUTRAL] OK, wait, is that all that I can help answer for you on this?
[CUSTOMER][NEUTRAL] No, only just, just, I just want this information.
[AGENT][NEUTRAL] OK, uh, we do not give reference numbers to pick you, but you can use my name and today's date if you need to do so, OK?
[CUSTOMER][POSITIVE] OK, sure. Thank you so much for that. Could you please confirm your last initial?
[AGENT][NEUTRAL] Oh
[CUSTOMER][POSITIVE] OK. Thank you so much for that information. Thank you and it's really appreciated and very nice to talk with you. Thank you and have a wonderful day.
[AGENT][NEUTRAL] You were
[AGENT][POSITIVE] You as well, [PII] and thanks for calling APL. Bye-bye.
[CUSTOMER][POSITIVE] Thank you. Bye-bye.