AccountId: 011433970860
ContactId: 1f1cef79-5b5a-4595-94aa-0cbf96a8ebe5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 233399 ms
Total Talk Time (AGENT): 69028 ms
Total Talk Time (CUSTOMER): 73824 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/21/1f1cef79-5b5a-4595-94aa-0cbf96a8ebe5_20250121T19:41_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey [PII], my name is [PII]. I'm just calling to get a claim status on our patient, please.
[AGENT][NEUTRAL] I'm sure, [PII], I can assist you with claim status. Um, first, can I get a good callback number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes ma'am, it's [PII].
[AGENT][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] I'm sorry, you cut out. Could you please repeat the phone number?
[CUSTOMER][NEUTRAL] Hey, yeah, can you hear me? Sure, it's [PII].
[AGENT][NEUTRAL] Yeah, I can hear you now.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK. Thank you. Now, I need the policy number, please.
[CUSTOMER][NEUTRAL] Um, the member ID is 02427588.
[AGENT][NEUTRAL] Thank you. Now, please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] It's for [PII]. His date of birth is [PII].
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Thank you. Now I need the date of service and bill charges for the claim.
[CUSTOMER][NEUTRAL] OK, it's [PII] and the bill amount was 225.
[AGENT][NEUTRAL] OK, one moment, please.
[AGENT][NEUTRAL] OK. Yes, ma'am. We received that claim on [PII].
[CUSTOMER][NEUTRAL] I know
[AGENT][NEUTRAL] The claim processed on [PII].
[AGENT][NEGATIVE] The claim number is 353-0490 and I'm showing that this claim denied because the services are not covered under the policy.
[CUSTOMER][NEUTRAL] OK, um.
[CUSTOMER][NEUTRAL] So just out of curiosity is.
[CUSTOMER][NEUTRAL] Is there an issue with y'all need more information or y'all just don't cover period maintenance period?
[AGENT][NEUTRAL] Right, per maintenance is not covered.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, um, thank you very much. I will notate that, um, can I get that EOB uh faxed to us because we didn't get that one.
[AGENT][NEUTRAL] Um, yes, ma'am. I can fax you the ELB. What's your fax number, please?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] OK, so that's attention, [PII] [PII].
[CUSTOMER][NEUTRAL] Yes ma'am, and then Ey, can I get your reference number?
[AGENT][NEUTRAL] It'll be my name and today's date.
[CUSTOMER][POSITIVE] OK, thank you very much that'll be perfect.
[AGENT][NEUTRAL] OK. Is there anything else that I can assist you with?
[CUSTOMER][NEUTRAL] No ma'am, that was it.
[AGENT][POSITIVE] OK. Well, I thank you again, [PII], for calling ATL. You have a great rest of your day. Mm bye.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Mhm