AccountId: 011433970860
ContactId: 12030a36-23e8-4057-93bd-7d8ee0935392
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 269250 ms
Total Talk Time (AGENT): 86418 ms
Total Talk Time (CUSTOMER): 113714 ms
Interruptions: 1
Overall Sentiment: AGENT=0.7, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/11/12030a36-23e8-4057-93bd-7d8ee0935392_20250211T21:19_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from Pros office to check on the claim and reason.
[AGENT][NEUTRAL] Sure, I can assist you with claim status. Um, first, could I get your name again and a good callback number?
[CUSTOMER][NEUTRAL] Yeah, sure. My first name is [PII] and my last name initial is [PII].
[CUSTOMER][NEUTRAL] Could you please spell out your first name, please?
[AGENT][NEUTRAL] Yes, my name is [PII]. It's spelled [PII] and my last initial is [PII].
[CUSTOMER][POSITIVE] Thank you so much [PII].
[AGENT][POSITIVE] No problem. And could I get a good callback number just in case we're disconnected?
[CUSTOMER][NEUTRAL] Yeah, sure, but my callback number is [PII].
[CUSTOMER][NEUTRAL] Sorry, [PII].
[AGENT][NEUTRAL] Thank you. Now, could I get the policy number, please?
[CUSTOMER][NEUTRAL] Yeah, sure. The policy number is
[CUSTOMER][NEUTRAL] 02184807 M as in Mike L as in Lima number 8.
[AGENT][NEUTRAL] Thank you. Now, please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Yeah, sure. The patient name is [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK and the date of service and bill charges on the claim, please.
[CUSTOMER][NEUTRAL] Yeah, sure. The date of service is [PII] and the total bill amount was
[CUSTOMER][NEUTRAL] $760.96.
[AGENT][NEUTRAL] OK. And do you have a claim number?
[CUSTOMER][NEUTRAL] Oh please, yes, I have the claim number. The claim number is 3553691.
[CUSTOMER][NEUTRAL] You
[AGENT][NEUTRAL] OK. Yes, ma'am. I'm showing that this claim denied because this policy expired on
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Uh, may I know the policy effective date, please?
[AGENT][NEUTRAL] Yes, and just let me advise you that verification of coverage does not guarantee payment of claims. The effective date on this policy was [PII] and it expired on.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, [PII]. I'm sorry, expired on [PII].
[CUSTOMER][POSITIVE] Yes, thank you so much. The effective date is [PII], right? That is [PII]. And the expiry date on [PII], right?
[AGENT][POSITIVE] Yes, that's correct. Yes, ma'am.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Yes, thank you so much for that confirming. So that this date of service was [PII], so that this claim was denied as policy coverage was terminated, right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] Yes, thank you so much for that confirming. May I know the call reference number, please?
[AGENT][NEUTRAL] So the reference number, you can use my name and today's date. Is there anything else that I can assist you with?
[CUSTOMER][NEUTRAL] Uh, could you please repeat one more time that your first name and the initial last name initial, please?
[AGENT][NEUTRAL] Yes, my first name is [PII]. It's spelled [PII] My last initial is [PII].
[CUSTOMER][NEUTRAL] That is [PII] I M, right?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][POSITIVE] Yes, thank you so much for that information. Before that, may I know if there is any secondary insurance for this patient?
[AGENT][NEUTRAL] Please repeat the question.
[CUSTOMER][NEUTRAL] May I know if there is any secondary, any other secondary insurance?
[AGENT][NEUTRAL] This is secondary insurance. This is the secondary insurance policy. Mhm.
[CUSTOMER][NEUTRAL] For the patient
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you so much for that confirming. That's all now. Thanks for listening. Have a great day bye.
[AGENT][POSITIVE] Thank you, [PII], for calling APL. You have a great day. Bye.