AccountId: 011433970860
ContactId: 29796c9c-762e-4831-bddf-04c8b1ae107c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 512700 ms
Total Talk Time (AGENT): 60328 ms
Total Talk Time (CUSTOMER): 75310 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=-2.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/13/29796c9c-762e-4831-bddf-04c8b1ae107c_20250313T16:25_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Can you hear me?
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII]. My name is [PII] calling for Coa Health Services to check on the status of the claim. Could you please spell your name for me?
[AGENT][NEUTRAL] Um, I'm so sorry, [PII], um, I, I couldn't quite hear, uh, we were needing to check on a claim, is that what you said?
[CUSTOMER][NEUTRAL] Uh, yes, uh, my name is [PII] calling for Coa Health Services to check on the status of a claim.
[AGENT][NEUTRAL] OK, yes, I can check on a claim for you. Uh, my name is spelled [PII]
[AGENT][POSITIVE] And then can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] Of course, [PII], that's gonna be [PII] and it's a direct line.
[AGENT][NEUTRAL] Alright thank you and then do you have the policy number?
[CUSTOMER][NEUTRAL] Obviously.
[CUSTOMER][NEUTRAL] Policy number is gonna be 02304088 M as in Mike L as in Lima 8.
[AGENT][NEUTRAL] And what was the name and date of birth for the insured?
[CUSTOMER][NEUTRAL] Member name is [PII].
[CUSTOMER][NEUTRAL] And the date of birth is gonna be?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and what was the date of service for this claim?
[CUSTOMER][NEUTRAL] Um, yes, the first one is [PII] I mean [PII].
[CUSTOMER][NEUTRAL] For the total bill amount of $680 even.
[AGENT][NEUTRAL] I'm sorry, that was $688?
[CUSTOMER][NEUTRAL] 80,680,680.
[AGENT][NEUTRAL] 80.
[AGENT][POSITIVE] OK, got it, thank you one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so we did receive this claim, uh, we were unable to pay a benefit as uh kinesiology, speech, or occupational therapy are not covered benefits under this policy.
[CUSTOMER][NEUTRAL] Like
[AGENT][NEUTRAL] And I can send you this EOB if you need it.
[CUSTOMER][NEUTRAL] Yes, of course, I need the UB. Before that, I just wanna verify the claim was submitted as a physical therapy, not occupation uh speech therapy. So basically, physical therapy is uh covered under this patient.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so that's what we have it as if you'll give me one moment, um, I'm gonna put you on a brief hold and just to review uh what was submitted to us.
[CUSTOMER][NEGATIVE] All right then yeah take your time please [PII]. You are on hold.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] Hm
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.