AccountId: 011433970860
ContactId: 1cf2eb80-c9e9-4767-ad8b-029c86c412a5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 219080 ms
Total Talk Time (AGENT): 81786 ms
Total Talk Time (CUSTOMER): 71139 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/24/1cf2eb80-c9e9-4767-ad8b-029c86c412a5_20250224T21:39_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII] I'm just calling to check status on one claim that we have on file.
[AGENT][NEUTRAL] OK, sure, I can assist you with claim status and may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And this is your personal policy or you're calling from providers, Ms. [PII]?
[CUSTOMER][NEUTRAL] I'm calling from a provider's office.
[AGENT][NEUTRAL] OK. All right. And what's the name of the facility from my location?
[CUSTOMER][NEUTRAL] Uh, this is for, um, CMC faculty physicians or Carolina's Medical Center.
[AGENT][NEUTRAL] OK, thank you. May I have the patient's policy number?
[CUSTOMER][NEUTRAL] Sure, it is, give me one second, let me check my.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] OK. So the policy number is
[CUSTOMER][NEUTRAL] 01.
[CUSTOMER][NEUTRAL] 877165 M as in Mary, L as in love, the number 7.
[AGENT][NEUTRAL] Thank you. And may I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][NEUTRAL] Thank you. And what is the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] Uh, the 7th is, um, [PII], and the big amount is for [PII].
[AGENT][NEUTRAL] OK, let me see if I can find this claim for you and that was [PII], correct?
[CUSTOMER][POSITIVE] That's correct.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] OK.
[AGENT][NEGATIVE] All right, we processed the claim [PII] and the claim was denied. The reason for the denial is that the service was rendered after coverage was terminated.
[CUSTOMER][NEUTRAL] OK, when did the, um, the coverage turn?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]. So what was the um effective date?
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] OK. The effective date on this one was [PII].
[CUSTOMER][NEUTRAL] OK, can I please have your name and the call reference number?
[AGENT][NEUTRAL] My name is [PII]. That's [PII]. Last initial is [PII], and we don't have reference numbers. You can use my name in today's date.
[CUSTOMER][POSITIVE] OK, thank you so.
[AGENT][POSITIVE] You're welcome and thank you for calling APL. Have a good day. Good afternoon.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Thank you, bye bye.