AccountId: 011433970860
ContactId: 1e09211c-6137-4679-b874-cbf52c4f58d6
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 584119 ms
Total Talk Time (AGENT): 109607 ms
Total Talk Time (CUSTOMER): 152380 ms
Interruptions: 3
Overall Sentiment: AGENT=-0.1, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/14/1e09211c-6137-4679-b874-cbf52c4f58d6_20250214T18:26_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from provider's office to take a claim status. Could you spell your name, please?
[AGENT][NEUTRAL] [PII] And what was your name?
[CUSTOMER][NEUTRAL] Uh, my name is [PII].
[AGENT][NEUTRAL] How do you spell your name?
[CUSTOMER][NEUTRAL] It's [PII]
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] Do you have a phone number I can get in case we get disconnected I can call you back.
[CUSTOMER][POSITIVE] That's right.
[CUSTOMER][NEUTRAL] Sure, I do. Uh, it's [PII].
[AGENT][NEUTRAL] And do you have the policy number?
[CUSTOMER][NEUTRAL] Yes, it's D 42018341.
[AGENT][NEUTRAL] That's not one of our policy numbers. Do you have their social?
[CUSTOMER][NEUTRAL] the social security number of last four digits are [PII].
[AGENT][NEUTRAL] I have to have the full social.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] That was [PII].
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] That's right.
[AGENT][NEUTRAL] Hold on one moment.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] And what's the name?
[CUSTOMER][NEUTRAL] It's [PII], and the last name is [PII].
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] And the date of birth?
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Thank you, [PII], and you were needing claim status?
[CUSTOMER][NEUTRAL] Pardon, could you repeat that again?
[AGENT][NEUTRAL] And you were needing claim status?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][POSITIVE] That's right.
[AGENT][NEUTRAL] Is this for medical or dental?
[CUSTOMER][NEUTRAL] And.
[CUSTOMER][NEUTRAL] H for America.
[AGENT][NEUTRAL] OK, I can look that up for you. What date of service?
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, was it physicians charge or was it for a facility bill, ER facility bill?
[CUSTOMER][NEUTRAL] Yeah, I'm calling from facility.
[AGENT][NEUTRAL] And what's the total charge?
[CUSTOMER][NEUTRAL] And what's the total charge?
[CUSTOMER][NEUTRAL] It's $2,561.83.
[AGENT][NEGATIVE] OK, we did get that claim. It was denied. This policy canceled 3-14-21.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Sorry for being on hold still, [PII]. Could you tell me the claim date?
[AGENT][NEUTRAL] The claim what now? I didn't understand you.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] What was your question? I didn't understand you.
[CUSTOMER][NEUTRAL] Uh, could you tell me the claim received date?
[AGENT][NEUTRAL] Hold on one moment.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] 10:30, 24.
[CUSTOMER][NEUTRAL] 10:33 0.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Is it, OK.
[CUSTOMER][NEUTRAL] Claim process down
[AGENT][NEUTRAL] 11 4 24.
[CUSTOMER][NEUTRAL] 11 3 224. OK. May I know the status of this claim?
[AGENT][NEUTRAL] May you know what now?
[CUSTOMER][NEUTRAL] May I know the, what are the status of this claim?
[AGENT][NEGATIVE] I just told you it was this policy canceled.
[AGENT][NEUTRAL] 314 of 21.
[CUSTOMER][NEUTRAL] May I know the reason for the cancellation?
[AGENT][NEUTRAL] Canceled 3 1421.
[CUSTOMER][NEUTRAL] 3 1421.
[AGENT][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] Uh, may I know for what, what is this? 3, 1421?
[AGENT][NEUTRAL] That means
[AGENT][NEGATIVE] The policy canceled. They did not have coverage after [PII].
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] The member has not, uh, not active for the date of service. Is that right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Just a moment.
[CUSTOMER][NEUTRAL] Could you tell me the policy effective date and termination date? Uh, you said the termination date. Could you tell me the policy effective date?
[AGENT][NEUTRAL] I just gave you the termination date.
[AGENT][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] Yeah, this is the term.
[AGENT][NEUTRAL] The effective date is [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Just a moment.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Just I want to know.
[CUSTOMER][NEUTRAL] Just a moment, [PII].
[CUSTOMER][NEUTRAL] Thank you for being on hold, [PII]. Could you tell me the insurance name? Here I can say it's Commercial Primary.
[AGENT][NEUTRAL] The insurance, our insurance name?
[CUSTOMER][NEUTRAL] Is that right?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Is APL.
[CUSTOMER][NEUTRAL] APL
[CUSTOMER][NEUTRAL] Pardon, could you repeat that again?
[AGENT][NEUTRAL] APL.
[CUSTOMER][NEUTRAL] APL
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Just a moment.