AccountId: 011433970860
ContactId: 1cb1099c-08ca-42fb-92e7-e9ef1f3f91f7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 326570 ms
Total Talk Time (AGENT): 97615 ms
Total Talk Time (CUSTOMER): 107127 ms
Interruptions: 1
Overall Sentiment: AGENT=0.2, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/06/1cb1099c-08ca-42fb-92e7-e9ef1f3f91f7_20250606T19:38_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm calling for medical specialist for [PII]. I verify the EUB and this call is made for additional information about the denial. Please note the call will be monitored and recorded for quality and training purposes.
[AGENT][NEUTRAL] OK, I can get clarification regarding that claim for you. Uh, [PII], can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Yeah, callback number is [PII]. That's a direct line.
[AGENT][NEUTRAL] OK, thank you. And then do you have that policy number?
[CUSTOMER][NEUTRAL] Let's see
[CUSTOMER][NEUTRAL] Member ID number?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yeah. It's 123 0494.
[AGENT][NEUTRAL] OK, and then uh what was the name and date of birth for the member, please?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] First name is [PII]. Last name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you for verifying that. Uh, do you have this claim number [PII]?
[CUSTOMER][NEUTRAL] Claim number, just a second, let me take a look for that.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, I have the claim number. The claim number is 35 3605158.
[AGENT][NEUTRAL] OK, thank you. One moment please.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK, so yes, um, I will begin by saying [PII] that the policy number you gave me is not the policy number that was affiliated with this claim. Uh, we were unable to pay a benefit as the services were rendered after coverage was terminated. The last policy they had with us terminated [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, just a second.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] So do you mean if patient is not eligible for, for this state of service?
[AGENT][NEUTRAL] Could you repeat that? I'm sorry.
[CUSTOMER][NEUTRAL] Oh, so just need to confirm for this one, the patient is not eligible for this state of service, right?
[AGENT][NEUTRAL] That's correct they had no active coverage during that date of service.
[CUSTOMER][NEUTRAL] OK. And if you don't mind, may I get the effective date and the policy, sorry, termination date once more?
[AGENT][NEUTRAL] OK, yes, so, um, the policy number, the last one, the one that uh the claim went to is a different policy number than the one that you had originally given me so whenever you're ready I can go ahead and give you that first.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, sure. May I get that?
[AGENT][NEUTRAL] Yes, it is 01.
[AGENT][NEUTRAL] 61
[AGENT][NEUTRAL] 7661.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and so this policy mhm that was [PII].
[CUSTOMER][NEUTRAL] And the effective date?
[AGENT][NEUTRAL] And it did terminate [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII]. Just a second.
[CUSTOMER][NEUTRAL] Just a second.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK. Does the policy got uh renewed after the termination?
[AGENT][NEUTRAL] This was the last policy they had with us, so they had nothing active after [PII].
[CUSTOMER][POSITIVE] OK, thank you so much for that information and uh.
[CUSTOMER][NEUTRAL] Before getting the reference, could you please spell your name for me?
[AGENT][NEUTRAL] Yeah, it's [PII]
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] OK. Thank you so much and make it the reference for our call today.
[AGENT][NEUTRAL] Reference number would just be my first name, last initial, and today's date. Uh, so my last initial is [PII] Uh, was there anything else I could help you with?
[CUSTOMER][POSITIVE] Uh, no, I got the all the information. Thank you so much for your assistance. Have a great day and happy weekend. Bye-bye.
[AGENT][POSITIVE] Of course, yeah, thanks for calling APL you too bye bye.