AccountId: 011433970860
ContactId: 19cd75a2-8690-4556-a230-d95cac8094c8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 285589 ms
Total Talk Time (AGENT): 75521 ms
Total Talk Time (CUSTOMER): 95490 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/31/19cd75a2-8690-4556-a230-d95cac8094c8_20250131T13:51_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh, hi, this is [PII]. I'm calling for the provider to check on additional information about the claim that has been denied. And please note this call will be monitored and recorded for quality and training purposes.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] I'm sure, yeah, sure, [PII], I can assist you with client status. Um, first, could I get a good callback number in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure, so the callback number is [PII] and it's a direct line.
[AGENT][NEUTRAL] Thank you. Now, I need the policy number, please.
[CUSTOMER][NEUTRAL] Uh, sure. The policy number is
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK, that's 013.
[CUSTOMER][NEUTRAL] 97449 M as in Mike L as in Lima 8.
[AGENT][NEUTRAL] Thank you. Now, please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Patient's name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] One moment, please.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] And the date of service and bill charges on the phone, please.
[CUSTOMER][NEUTRAL] The date of service is for [PII].
[CUSTOMER][POSITIVE] And let me get that total amount for you.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] So total bill amount is $1,152.55.
[AGENT][NEUTRAL] OK, one moment, I'm waiting on my system.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] Do you have a claim number?
[CUSTOMER][NEUTRAL] Yes, ma'am. Just a moment, let me get that claim number for you.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] That's 354-739-8.
[AGENT][NEUTRAL] OK. Yes, ma'am. We received that claim on [PII].
[AGENT][NEUTRAL] It processed on [PII], and this claim denied because this policy will just let me advise you that verification of coverage does not guarantee payment of claims. Um, the effective date on this policy was [PII], and I'm showing that this policy expired on [PII].
[CUSTOMER][NEUTRAL] OK, got it. Just to not say the name of the patient did not have a coverage for the date of service, right?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] Got it, just a moment.
[AGENT][POSITIVE] OK, no problem.
[CUSTOMER][POSITIVE] Thank you so much.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Uh, do you know if the patient has any other health insurance?
[AGENT][NEUTRAL] Um, no, I'm not showing any on file with us.
[CUSTOMER][NEUTRAL] Got it, just a moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, thank you so much for that information, EV and uh upon checking here, I do not have any more questions for this claim or for this patient. In that case, can I please have the call reference number for today's call?
[AGENT][NEUTRAL] Yes, for the reference number, you can use my name and today's date. Is there anything else that I can assist you with?
[CUSTOMER][POSITIVE] Uh, no, nothing else. Thank you so much for that information and I hope you have a great rest of your day ahead.
[AGENT][NEUTRAL] You do the same, [PII]. Thank you for calling APL. Mm bye.
[CUSTOMER][POSITIVE] Bye bye. Happy weekend.
[AGENT][NEUTRAL] Same to you. Bye.