AccountId: 011433970860
ContactId: 1742f7ab-5fec-4dd4-be74-82d23431cc8d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 360000 ms
Total Talk Time (AGENT): 71993 ms
Total Talk Time (CUSTOMER): 94929 ms
Interruptions: 1
Overall Sentiment: AGENT=0.3, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/29/1742f7ab-5fec-4dd4-be74-82d23431cc8d_20250129T18:09_UTC.wav
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[AGENT][NEUTRAL] For calling APL, this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] call from office.
[AGENT][NEUTRAL] I didn't understand your name ma'am.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]? OK, and how can I help you, [PII]?
[CUSTOMER][NEUTRAL] Calling from part office.
[AGENT][NEUTRAL] And how can I help you?
[CUSTOMER][NEUTRAL] Claim status.
[AGENT][NEUTRAL] OK, and if I can get the policy number and a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes, uh, the phone number, just a moment.
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] 758 6.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] The policy number?
[CUSTOMER][NEUTRAL] Just a moment.
[CUSTOMER][POSITIVE] Just right here.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So the member ID number is 02063831.
[AGENT][NEUTRAL] And the patient's name and date of birth?
[CUSTOMER][NEUTRAL] The patient name is [PII]. Date of birth is
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Alright, thank you for that information, um, [PII], and you said that you're checking a claim status?
[CUSTOMER][NEUTRAL] 6
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Alright, what's the date of service and the total charge and we can assist.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] The date of service is [PII].
[AGENT][NEUTRAL] In the amount?
[CUSTOMER][NEUTRAL] With the amount is $217.
[AGENT][NEUTRAL] OK, I'm showing that denied as office visits are not covered by the patient's policy. I show that the claim was received.
[CUSTOMER][NEUTRAL] So this is the office visit.
[AGENT][NEUTRAL] On
[AGENT][NEUTRAL] The claim was received [PII], processed [PII].
[CUSTOMER][NEUTRAL] Like.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] What's the claim number?
[AGENT][NEUTRAL] And that claim number is 3545539.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] And [PII], you can also check status on our online service center at [PII].
[CUSTOMER][NEUTRAL] So, um, you are saying that the office visit is not covered under the patient plan, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Just a moment.
[CUSTOMER][NEUTRAL] Just a moment
[CUSTOMER][NEUTRAL] And what type of plan is it?
[AGENT][NEUTRAL] Submit link plan.
[CUSTOMER][NEUTRAL] [PII], can you spell that?
[AGENT][NEUTRAL] M [PII]
[CUSTOMER][NEUTRAL] M [PII]
[AGENT][NEUTRAL] L [PII]
[CUSTOMER][NEUTRAL] L [PII]
[CUSTOMER][POSITIVE] Wow.
[CUSTOMER][NEUTRAL] Just a moment.
[AGENT][NEUTRAL] Anything else I can help with today, [PII]?
[CUSTOMER][NEUTRAL] It's like a
[CUSTOMER][NEUTRAL] Just a moment, please.
[CUSTOMER][NEUTRAL] Just a moment.
[CUSTOMER][NEUTRAL] Can you spell your name, please?
[AGENT][NEUTRAL] [PII], first initial and last name is [PII], and anything else?
[CUSTOMER][POSITIVE] I did it, you, you, you, you're going so fast. It's [PII]?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] What's your first name is?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] And YA Last Nation.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Just for now.
[CUSTOMER][NEUTRAL] Reference, please.
[AGENT][NEUTRAL] That's my reference the reference is my name in today's date.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] It's [PII], right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] OK. Thank you so much. Have a great day.
[AGENT][POSITIVE] You're welcome, [PII]. Thanks for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] Mhm.