AccountId: 011433970860
ContactId: 35e2b998-7dc7-4a2e-957a-79e2e36daa7c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 440760 ms
Total Talk Time (AGENT): 118228 ms
Total Talk Time (CUSTOMER): 72288 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=-0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/27/35e2b998-7dc7-4a2e-957a-79e2e36daa7c_20250327T18:31_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling for provider office to check on additional information about a claim that has been denied. Please note this call will be monitored and recorded for quality and training purposes.
[AGENT][POSITIVE] OK, I'll be more than happy to help you with the denial of clarity. And may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII] and it's a direct line.
[AGENT][NEUTRAL] Thank you for that. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] 1293667. M as in Mike Lima number 7.
[AGENT][NEUTRAL] Thank you for that. And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] It's [PII]
[CUSTOMER][NEUTRAL] And the last name, [PII]. Date of birth, [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 or the claim number for the claim?
[CUSTOMER][NEUTRAL] [PII] and the bill amount I have it is.
[CUSTOMER][NEUTRAL] Hold on.
[CUSTOMER][NEUTRAL] Loading.
[CUSTOMER][NEUTRAL] Claim number 3572421.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] 42.
[AGENT][NEUTRAL] Is it 3572412?
[CUSTOMER][NEUTRAL] 3572421.
[AGENT][NEUTRAL] OK, I don't see a claim and we have that same exact claim, but it's um 12. OK.
[AGENT][NEUTRAL] Hold on one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, we don't have a claim ending in 21, but we do have 3572412. What's the name of your provider?
[CUSTOMER][NEUTRAL] Provider name it is [PII].
[AGENT][NEUTRAL] Hold on one moment.
[AGENT][NEUTRAL] Do you mind if I place you on just a brief hold?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Hello [PII].
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] Thank you so much for holding. I apologize for that wait. So with the um claim number that you gave,
[AGENT][NEUTRAL] Um, well, there's a few things. The policy, um, we don't have a policy that was active on the data service, but this claim number is, it was created in error, like it's not attached to anything.
[CUSTOMER][NEUTRAL] OK. And what is the policy effective date and the term date?
[AGENT][NEUTRAL] Hold on 1 2nd.
[AGENT][NEUTRAL] The last policy they had with us was effective from [PII].
[CUSTOMER][NEUTRAL] And after that policy never been active.
[AGENT][NEUTRAL] With APL, they may have other insurance, but it's not with APL.
[CUSTOMER][NEUTRAL] OK. Do you have any other insurance with AA? Do you have any information?
[AGENT][NEUTRAL] We don't have any information of their other insurance, no, ma'am.
[CUSTOMER][NEUTRAL] OK. For this, ma'am, I have another data services. will you able to check that one?
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] There is
[AGENT][NEUTRAL] So there is a claim number 3572412, but that's like the other one, it was created, this is saying it was created in error, um, and also there was the policy wasn't active on the data service.
[CUSTOMER][NEUTRAL] OK. Can I get the call reference number?
[AGENT][NEUTRAL] So there's no call reference number, but you can use my name in today's date. The first initial to my last name is [PII].
[CUSTOMER][POSITIVE] Thank you so much for your time, I wish you have a great day.
[AGENT][POSITIVE] You're very welcome. Was there anything else I can assist you with today?
[CUSTOMER][NEUTRAL] No, that's it for the