AccountId: 011433970860
ContactId: 10f29819-0dbb-4ab7-8a85-f148d4331e88
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 529320 ms
Total Talk Time (AGENT): 181372 ms
Total Talk Time (CUSTOMER): 93450 ms
Interruptions: 4
Overall Sentiment: AGENT=0.6, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/02/10f29819-0dbb-4ab7-8a85-f148d4331e88_20250402T20:42_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes, hi, this is [PII] from provider's office to check on a client status.
[AGENT][NEUTRAL] OK. You said your name is [PII]. Is that correct?
[CUSTOMER][NEUTRAL] Yes, my name is [PII].
[AGENT][NEUTRAL] [PII] or [PII]
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] No, it is uh [PII]
[AGENT][NEUTRAL] Oh [PII], I'm sorry. OK, thank you. I'm sorry you're needing to check.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Status on one claim, is that correct?
[CUSTOMER][NEUTRAL] Actually.
[CUSTOMER][NEUTRAL] Yes, status of the one.
[AGENT][NEUTRAL] Hello.
[AGENT][NEUTRAL] One time?
[CUSTOMER][NEUTRAL] Yes, I need to check with, yes.
[AGENT][NEUTRAL] OK. So, can you hear me OK?
[CUSTOMER][NEUTRAL] Am I audible?
[AGENT][NEUTRAL] Yes, can you hear me? OK. Did you say that you have
[CUSTOMER][NEUTRAL] Yes, I can't hear you.
[CUSTOMER][NEUTRAL] Yes, I can hear you.
[AGENT][NEUTRAL] You have one claim to check status on, is that correct?
[CUSTOMER][NEUTRAL] Yes, that's right. I do have only one claim to check with the state.
[AGENT][POSITIVE] Yes. I can help you. Yes, I can help you. And what is your callback number?
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Yes the callback would be [PII] with no extension.
[AGENT][NEUTRAL] Thank you and the member's policy number?
[CUSTOMER][NEUTRAL] Um, is the member ID would be 02576516.
[AGENT][POSITIVE] OK, thank you. Give me a couple of moments please to get the member's information pulled up.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And any information that I do provide for you today, [PII] will be a verification of benefits and not a guarantee of payment. What is your patient's name please and date of birth?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] The first name is [PII]. Last name is [PII], and date of birth is on [PII].
[AGENT][POSITIVE] Thank you, one moment.
[AGENT][NEUTRAL] And what is the date of service and total bill amount for her place?
[CUSTOMER][NEUTRAL] In the services on [PII] of total bill amount $618 even.
[AGENT][NEUTRAL] 618. Is that correct?
[CUSTOMER][POSITIVE] Yes, that's right, huh.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, so this claim was received.
[AGENT][NEUTRAL] The received date is [PII].
[CUSTOMER][NEUTRAL] Right
[AGENT][NEGATIVE] It was processed and denied on [PII].
[AGENT][NEUTRAL] The claim number is 357.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] 3221.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Thank you. Can I have the reason for the?
[AGENT][NEUTRAL] And the reason for the denial on this claim, [PII]?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Our records indicate.
[AGENT][POSITIVE] That premium.
[AGENT][NEUTRAL] For this service date?
[AGENT][NEGATIVE] Was not received.
[AGENT][NEUTRAL] Therefore, benefits are not payable.
[CUSTOMER][NEUTRAL] Can I have that again?
[AGENT][NEUTRAL] Our records indicate.
[AGENT][POSITIVE] That premium.
[AGENT][NEUTRAL] For this service date?
[AGENT][NEGATIVE] Was not received.
[AGENT][NEUTRAL] Therefore, benefits are not payable.
[CUSTOMER][NEUTRAL] Can I have the effective one too?
[AGENT][NEUTRAL] The effective date is [PII].
[AGENT][NEUTRAL] The termination date is [PII].
[CUSTOMER][NEUTRAL] Thank you. And uh can I have the call reference number?
[AGENT][NEUTRAL] You're welcome. And if you
[AGENT][NEUTRAL] Yes ma'am, and so first off, if you need a, uh, let me give you a website for our portal, if you need a copy of the explanation of benefits, you should be able to print it by going to [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And you will use my name along with today's date as your call reference number.
[CUSTOMER][NEUTRAL] Could you please spell your name?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Yes, thank you.
[AGENT][POSITIVE] You're welcome. And is there anything else I can help you with today?
[CUSTOMER][POSITIVE] Um, no, I've got the required information and thank you so much for assisting me. Have a great day. Bye for now.
[AGENT][POSITIVE] Oh, well, you've, mm bye-bye and thank you again for calling APL. I hope you have a nice day as well.
[CUSTOMER][POSITIVE] Thank you. Bye-bye.
[AGENT][POSITIVE] Um, you're welcome. Bye bye.
[AGENT][NEUTRAL] Man first.
[AGENT][NEGATIVE] You got to be kidding me.
[AGENT][NEUTRAL] Like, really?
[AGENT][NEUTRAL] Uh,
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] God bless.
[AGENT][NEUTRAL] They're gonna
[AGENT][NEUTRAL] Make me late today, you wait and see.
[AGENT][NEGATIVE] I still, I can't do it for 10 minutes.
[AGENT][NEUTRAL] I can't go on there that long.
[AGENT][NEGATIVE] I've gotten so damn fat.
[AGENT][NEUTRAL] To take the truth.
[AGENT][NEUTRAL] Hello?