AccountId: 011433970860
ContactId: 2da4acda-c2be-45d4-b38a-7f2925200d7b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 199149 ms
Total Talk Time (AGENT): 77098 ms
Total Talk Time (CUSTOMER): 60214 ms
Interruptions: 0
Overall Sentiment: AGENT=2.1, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/17/2da4acda-c2be-45d4-b38a-7f2925200d7b_20250117T14:17_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Good morning, [PII]. This is [PII] is spelled [PII] I calling from Washington University School of Medicine. I need your help check a one patient claim.
[AGENT][POSITIVE] OK, well, I'll be more than happy to help you with the claim status, and may I have a good contact number in case we're disconnected and the policy number?
[CUSTOMER][NEUTRAL] [PII] direct line.
[CUSTOMER][NEUTRAL] And the policy ID 01897871.
[AGENT][POSITIVE] Thank you. Hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Patient name is [PII] [PII].
[AGENT][NEUTRAL] Thank you for that. And all the information provided is a verification of benefits, not a guarantee of payment. And may I have the date of service for the claim you like me to check on?
[CUSTOMER][NEUTRAL] And the service is [PII]. Total charge is 395.
[AGENT][NEUTRAL] Alright, hold on one moment.
[AGENT][NEUTRAL] 395.
[AGENT][NEUTRAL] All right, so I just located the claim and I'm waiting for it to come up now. Hold on one moment.
[AGENT][NEUTRAL] Alright, so I'm showing we received the claim on [PII].
[AGENT][NEUTRAL] The claim number is 353.
[AGENT][NEUTRAL] 7892.
[AGENT][NEUTRAL] And on [PII], the claim was denied because the outpatient benefit for the calendar year was met.
[CUSTOMER][NEUTRAL] Uh, what's that? Outpatient benefits?
[AGENT][NEUTRAL] For the calendar year?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Has been met.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Can you fax this LLB?
[AGENT][NEUTRAL] Sure, what's a good fax number for you?
[CUSTOMER][NEUTRAL] [PII]. You, you can put attention Y I.
[AGENT][NEUTRAL] OK, and that was [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] All right, and I'm sending that over to you now. Was there anything else I can assist you with today?
[CUSTOMER][NEUTRAL] And uh do you have car reference number?
[AGENT][NEUTRAL] So there's no call reference number, but you can use my name in today's date, and the first initial to my last name is [PII].
[CUSTOMER][POSITIVE] OK, great. Thank you.
[AGENT][POSITIVE] You're welcome and thanks for calling APL. I hope you have a great day and a great weekend.
[CUSTOMER][NEUTRAL] You too. Bye-bye.
[AGENT][POSITIVE] Thank you. Bye bye.