AccountId: 011433970860
ContactId: 29fa779f-ac80-4186-b383-6123c91b08cb
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 311910 ms
Total Talk Time (AGENT): 103947 ms
Total Talk Time (CUSTOMER): 85695 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/18/29fa779f-ac80-4186-b383-6123c91b08cb_20250618T18:44_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Hi, [PII]. This is [PII]. I'm calling from Oxford Diagnostic Center. I would like to get uh claim status. Can you help with that?
[AGENT][NEUTRAL] I'm sure, [PII], I can assist you with claim status. Um first, I'll need a good callback number just in case we're disconnected.
[CUSTOMER][NEUTRAL] Yeah, sure. It's my callback number [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. Now, I need the policy number, please.
[CUSTOMER][NEUTRAL] Yeah, sure.
[CUSTOMER][NEUTRAL] The policy number?
[CUSTOMER][NEUTRAL] 91
[CUSTOMER][NEUTRAL] 01
[CUSTOMER][NEUTRAL] 13.
[AGENT][NEUTRAL] OK, that's not one of our policy numbers. Do you have the member's social?
[CUSTOMER][POSITIVE] Yeah, I do.
[AGENT][NEUTRAL] OK. What's the social?
[CUSTOMER][NEUTRAL] It's like [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and please verify the member's name and date of birth.
[CUSTOMER][NEUTRAL] [PII] name is like [PII].
[CUSTOMER][NEUTRAL] And the last name [PII].
[CUSTOMER][NEUTRAL] And coming to date of birth, it's [PII].
[AGENT][NEUTRAL] OK. And I have her policy number here.
[AGENT][NEUTRAL] Um, it is 00910113.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Starting to go to.
[AGENT][NEUTRAL] OK, and you need claim status. Um, what's the date of service and bill charges on the claim?
[CUSTOMER][NEUTRAL] Yeah this one.
[CUSTOMER][NEUTRAL] Yeah, the date of service is uh [PII].
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] The total charges are like $213 even.
[AGENT][NEUTRAL] OK, you said [PII] for $215 or $213?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] $213.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] OK, yes, we received that claim on [PII].
[AGENT][NEUTRAL] The claim processed on [PII].
[AGENT][NEUTRAL] The claim number is 3411168.
[AGENT][NEUTRAL] And um this claim denied because according to the diagnosis code, um it was for screenings and screenings are not covered under the policy.
[AGENT][NEUTRAL] The diagnosis code has to be related to an illness or an injury.
[CUSTOMER][NEUTRAL] OK, not call under the member's plan, right?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] OK. And do you have you will be with you?
[AGENT][NEUTRAL] Um, I can fax it to you. What's your fax number?
[CUSTOMER][NEUTRAL] Yeah, just a moment.
[CUSTOMER][NEUTRAL] A fax number.
[CUSTOMER][NEUTRAL] Yeah, it's 833.
[CUSTOMER][NEUTRAL] 826
[CUSTOMER][NEUTRAL] 684 3.
[AGENT][NEUTRAL] OK. So that's attention Mark [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Yes, you're right.
[AGENT][NEUTRAL] OK. You should receive it in about 10 minutes. Is there anything else I can assist you with?
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Yeah, no, can I get your call reference number?
[AGENT][NEUTRAL] Yes, for the reference number, you can use my name and today's date.
[CUSTOMER][NEUTRAL] You said your name is [PII], right?
[AGENT][NEUTRAL] Um, it's [PII] spelled [PII] Last initial is [PII], and today's date.
[CUSTOMER][POSITIVE] Yeah, thank you. We got it.
[AGENT][POSITIVE] OK. Well, I thank you, [PII], for calling APL. You have a great rest of your day. Mm bye.
[CUSTOMER][POSITIVE] Yeah, thank you, bye.
[AGENT][NEUTRAL] Hm