AccountId: 011433970860
ContactId: 0ece99c3-e97e-4182-bbe8-caffb600c6ac
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 252600 ms
Total Talk Time (AGENT): 67242 ms
Total Talk Time (CUSTOMER): 86953 ms
Interruptions: 0
Overall Sentiment: AGENT=0, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/30/0ece99c3-e97e-4182-bbe8-caffb600c6ac_20250530T14:35_UTC.wav
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[CUSTOMER][NEUTRAL] Like
[CUSTOMER][NEUTRAL] Hello.
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Um, good morning. My name is [PII]. I'm calling from our provider office to check the status of a claim.
[AGENT][NEUTRAL] I can help you with claim status, [PII]. Can I get a good callback number in case we get disconnected?
[CUSTOMER][NEUTRAL] Um, it's [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And do you have the policy number?
[CUSTOMER][NEUTRAL] Uh hello?
[CUSTOMER][NEUTRAL] Uh yeah, patients policy number is 021.
[CUSTOMER][NEUTRAL] 315.
[CUSTOMER][NEUTRAL] 61
[AGENT][NEUTRAL] OK, one moment while I look that up.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And can you verify the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] It's [PII]. Date of birth is uh [PII].
[AGENT][NEUTRAL] Thank you for verifying that. And do you have the claim number or date of service?
[CUSTOMER][NEUTRAL] Uh, date of service is [PII].
[CUSTOMER][NEUTRAL] The total amount of the claim is $406 but the remaining is $70.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, give me just a moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Give me just a moment.
[AGENT][NEUTRAL] OK, it looks like we received that claim on [PII]. It was processed on the same day, [PII].
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEGATIVE] It looks like that was denied, and let me see why.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, office visits aren't covered under this policy.
[CUSTOMER][NEUTRAL] OK, so it will be patient responsibility in that case.
[AGENT][NEUTRAL] Uh, we don't determine patient responsibility.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, may I have the
[CUSTOMER][NEUTRAL] Sorry, may I have the
[CUSTOMER][NEUTRAL] Uh, claim number please?
[AGENT][NEUTRAL] Sure, the claim number is 3517.
[AGENT][NEUTRAL] 294.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] and OK, so just to be clear about the denial, so this her hair coverage does not.
[CUSTOMER][NEGATIVE] Covers office visits. That's not a benefit included on the coverage. That's why I got denied.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, well, uh, in that case, um, may I have, uh, your name again, uh, and the initial of your last name and a reference number?
[AGENT][NEUTRAL] We don't have reference numbers, but you can use my name, today's my name and last initial in today's date. So [PII], and today's date.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK. OK, [PII], thank you very much for the information. That, that will be all. Thank you and have a nice day.
[AGENT][POSITIVE] Thank you for calling APL. Have a great day.
[CUSTOMER][POSITIVE] Thanks