AccountId: 011433970860
ContactId: 164714f0-2c2c-444e-990b-fa3dcf055b34
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 634640 ms
Total Talk Time (AGENT): 100529 ms
Total Talk Time (CUSTOMER): 108529 ms
Interruptions: 1
Overall Sentiment: AGENT=1.5, CUSTOMER=-1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/07/164714f0-2c2c-444e-990b-fa3dcf055b34_20250207T16:27_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Uh, hi, my name is [PII] calling you from the doctor's office to check on the claims.
[AGENT][NEUTRAL] OK, sure, I can assist you with claims, Mr. [PII], and may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] It's uh [PII].
[AGENT][POSITIVE] Thank you, and you're calling from?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Uh, what did you say?
[AGENT][NEUTRAL] Where are you calling from, Mr. [PII]?
[CUSTOMER][NEUTRAL] Uh, ULP service area ULP stands for University of political and physician.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Thank you. And may I have the patient's policy number?
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] 02441372.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] In
[AGENT][NEUTRAL] OK, perfect, thank you. And may I have the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] [PII], sorry, [PII], charge $205 even.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And for future you can check claim status online through our website at [PII] and that's just optional and let me pull this ELB OK? one moment.
[CUSTOMER][POSITIVE] OK thank you.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah, it's gonna be one more minute.
[CUSTOMER][POSITIVE] Take your time.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Much time on you already.
[AGENT][NEUTRAL] Right, we process the claim on [PII].
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] And the claim was denied. The reason for this denial is there is a non-covered procedure.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Non court procedure.
[CUSTOMER][NEUTRAL] I surgical pathology.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] Oh, and when it got denied.
[AGENT][NEUTRAL] On [PII].
[CUSTOMER][NEUTRAL] On the same day.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Can I have the claim number?
[AGENT][NEUTRAL] That is claim number 354-7222.
[CUSTOMER][NEUTRAL] To
[CUSTOMER][NEUTRAL] And can you fax this over to me? Can you do that?
[AGENT][NEUTRAL] What is the fax number?
[CUSTOMER][NEUTRAL] Um [PII]. Attention to my name, it's [PII]
[AGENT][NEUTRAL] OK. [PII].
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] [PII], yes.
[AGENT][NEUTRAL] OK. Do you mind holding for me while I send this out to you while I got you on the line?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you for holding and being patient for me, Mr. [PII]. OK, I went ahead and send that over to you. It should be there in a few minutes. Is there anything else I can help you with today?
[CUSTOMER][NEUTRAL] Uh, no, I had only one claim with me, and can I have the reference and what is your name? How can you said? I'm so sorry.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] My name is [PII]. That's [PII].
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] And can I have the reference number for this call?
[AGENT][NEUTRAL] We don't have a reference numbers, you can use my name in today's date.
[CUSTOMER][POSITIVE] OK. Thank you so much. So have a great day, OK? God bless you. Bye. Mhm.
[AGENT][POSITIVE] You as well. Thank you. You as well. Thank you for calling APL bye-bye.
[CUSTOMER][NEUTRAL] OK.