AccountId: 011433970860
ContactId: 157f4579-c6e8-4c53-bf20-8c720900afb0
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 335820 ms
Total Talk Time (AGENT): 133424 ms
Total Talk Time (CUSTOMER): 144791 ms
Interruptions: 8
Overall Sentiment: AGENT=0.6, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/10/157f4579-c6e8-4c53-bf20-8c720900afb0_20250410T20:48_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII]. I'm calling from O Medical Center looking for a claim status.
[AGENT][NEUTRAL] OK, well, I can definitely help you with the claim status, [PII]. May I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] Thank you for that. And how many claims do you have in total today?
[CUSTOMER][NEUTRAL] I have just one clear manner. Yes, it's 02405607. No, it's 02405607.
[AGENT][NEUTRAL] Alright and may I have the member's policy number?
[AGENT][NEUTRAL] 02405407. Is that correct?
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEUTRAL] It is it's filling pouring uh reprocessing.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Yes, it's [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 bill for the claim?
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] $1,226 even.
[AGENT][NEUTRAL] So [PII] $1,226.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] And can you verify the name of the provider's office on the claim?
[CUSTOMER][NEUTRAL] Yes, it's also Medical Center.
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEUTRAL] Or.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Uh.
[AGENT][NEUTRAL] Alright, so I'm showing the claim was received on [PII].
[AGENT][NEUTRAL] The claim number is 350.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] 7248.
[AGENT][NEUTRAL] And on [PII], the claim was denied.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] Because
[CUSTOMER][NEUTRAL] Uh, sorry, may I know the dinner date again?
[CUSTOMER][NEUTRAL] What did the dinner date?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And then I'll be
[AGENT][NEUTRAL] Kinesiology, K I N E S I O L O G Y.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Speech and occupational therapy are not covered benefits under this policy.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK. Could you please uh spell that, the first sentence?
[CUSTOMER][NEUTRAL] It's [PII]
[AGENT][NEUTRAL] [PII] igloo, [PII] Nancy, [PII].
[AGENT][NEUTRAL] S [PII] Sam,
[AGENT][POSITIVE] I [PII] igloo,
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII],
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh, OK. I'm not covered under this plan.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Could you please fax us the Denaliobi.
[AGENT][NEUTRAL] Of course. What's a good fax number for you?
[CUSTOMER][NEUTRAL] Yes, allow me a moment.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] That was [PII]. Is that correct?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEUTRAL] Uh,
[AGENT][NEUTRAL] All right, so I'm faxing the explanation of benefits over to you now. Was there anything else that I can assist you with today, [PII]?
[CUSTOMER][NEUTRAL] Yes, may I know the turnaround time to be of EV.
[AGENT][POSITIVE] Um, usually with fax it is typically um give it at least an hour for a fax. If you don't receive it by the end of day today, you can definitely give us a call back and we'll be more than happy to resend it.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. May I have the caller reference number?
[AGENT][NEUTRAL] Sure, there's no call reference number, but you can use my name in today's date, and again, that's [PII] First initial to my last name is [PII].
[AGENT][NEUTRAL] And today's date.
[CUSTOMER][POSITIVE] OK. Thank you so much for providing me all the information. Have a good day and bye-bye.
[AGENT][NEUTRAL] You're welcome, [PII]. Was there anything