AccountId: 011433970860
ContactId: 1e8cb7a0-b740-4ac6-a9c4-3429601e4cb1
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 251600 ms
Total Talk Time (AGENT): 114941 ms
Total Talk Time (CUSTOMER): 44938 ms
Interruptions: 0
Overall Sentiment: AGENT=1.7, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/07/1e8cb7a0-b740-4ac6-a9c4-3429601e4cb1_20250207T13:21_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my
[CUSTOMER][NEUTRAL] I'm calling to get claim status.
[AGENT][NEUTRAL] Hello.
[AGENT][NEUTRAL] I'm so sorry, but you.
[CUSTOMER][NEUTRAL] Hello, can you
[AGENT][NEUTRAL] It's going in and out.
[CUSTOMER][NEUTRAL] Can you hear me?
[AGENT][NEUTRAL] It's going in and out. I can hear a couple of words and I can't hear. Uh, for the moment, I can't hear you, but yes, ma'am, can you please give me your name again? Cause I didn't hear that.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Is that better?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][POSITIVE] OK. Hi, [PII]. And how can I help you today?
[CUSTOMER][NEUTRAL] Yeah, I'm trying to get claim status on a patient.
[AGENT][NEUTRAL] Yes, ma'am. I can help you with claim status. And what is your callback number?
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] Thank you. And the member's policy number?
[CUSTOMER][NEUTRAL] 018.
[CUSTOMER][NEUTRAL] 02768.
[AGENT][POSITIVE] OK [PII], thank you very much. Give me a moment uh to get the member's information pulled up please.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And [PII], any information that I do provide for you today would be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth?
[CUSTOMER][NEUTRAL] [PII] date of birth [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And the date of service and total bill amount for her please.
[CUSTOMER][NEUTRAL] That was [PII], and the bill amount was 396.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, so I do see that this claim was received. The received date was [PII].
[AGENT][NEUTRAL] It was processed and denied on [PII].
[AGENT][NEUTRAL] The claim number is 3491572.
[AGENT][NEUTRAL] And the reason for the denial on this, [PII], is that the service is not covered when performed in a doctor's office or clinic.
[AGENT][NEUTRAL] And if you need a copy of this EOB [PII], we do have a portal that you should be able to print it from now that you have the claim number.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] And our website for our portal is secured.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yes, ma'am, secure. [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right, I thank you [PII], and I hope you have a great weekend.
[AGENT][NEUTRAL] For you
[AGENT][POSITIVE] I hope you do too. Is there anything else that I can help you with today?
[CUSTOMER][POSITIVE] No, that's it for today thank you.
[AGENT][POSITIVE] OK, well, yes ma'am, you're certainly welcome and thank you again for calling APL.
[CUSTOMER][NEUTRAL] All right, bye bye.
[AGENT][NEUTRAL] All right, bye bye.