AccountId: 011433970860
ContactId: 36e35d95-a999-46f7-b1ef-cb178a1c63a8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 176360 ms
Total Talk Time (AGENT): 82362 ms
Total Talk Time (CUSTOMER): 91476 ms
Interruptions: 4
Overall Sentiment: AGENT=0.2, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/12/36e35d95-a999-46f7-b1ef-cb178a1c63a8_20250312T18:36_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], good morning. I'm [PII] calling from provider's office and I just need your help. Um, I have a question about claims please.
[AGENT][NEUTRAL] OK, is that a claim that has been processed? Are you checking claim status?
[CUSTOMER][NEUTRAL] Yeah, it has been processed. I just wanted more information. How was it processed, please? Yeah.
[AGENT][NEUTRAL] Yes
[AGENT][NEUTRAL] If you can provide the policy number and the claim number.
[CUSTOMER][NEUTRAL] Uh, I have the claim number under.
[CUSTOMER][NEUTRAL] 332-022-8
[AGENT][NEUTRAL] What's the policy number?
[CUSTOMER][NEUTRAL] For patient. Uh, policy number is
[CUSTOMER][NEUTRAL] 02289620
[AGENT][NEUTRAL] And what's a good phone number for you in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, give me one moment to pull up the file and we will proceed.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Verify the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] Um, [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Thank you for that. Do you have a copy of the explanation of benefits for that claim number?
[CUSTOMER][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] Yeah, I do. It's actually, I'm looking at it right now.
[AGENT][NEUTRAL] Can you turn to the back of that form?
[AGENT][NEUTRAL] Mhm. Turn on the back.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] And tell me what it says on the back.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh D2C7500 remark code um stating records indicate that the premium for this dated service was not received, therefore benefits are not payable.
[AGENT][NEUTRAL] OK, yeah, so I'm showing that the policy um is no longer active.
[AGENT][NEUTRAL] Um, let's see. Give me one moment.
[CUSTOMER][NEUTRAL] My data service was [PII].
[AGENT][NEUTRAL] Yeah, the policy termed [PII]. So at the time you received that explanation, we were trying to confirm eligibility. We did confirm and the policy termination was [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh, makes sense. OK, I thought I was just thinking.
[AGENT][NEUTRAL] So we did go back in and reprocess the claim, so you should have received an updated explanation of benefits.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And it's been mailed. You can now download it online at [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 60, but then you said this has been termed since [PII]. OK.
[AGENT][NEUTRAL] Yeah, we, it, it's just letting you know that the policy is termed.
[CUSTOMER][POSITIVE] Mhm. OK. Thank you so, so much. That helps a lot cause I wanna meet you before I bill November. Thank you, [PII]. Can I get a call reference number, please?
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] Right. All right.
[AGENT][NEUTRAL] Sure, you'll use my name in today's date, [PII] First initial last name is [PII], did you have any other questions I can help out with today?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Well, that's it. Thank you. Hope you have a good day.
[AGENT][POSITIVE] You're welcome. Thank you for calling ATL you do the same bye bye.
[CUSTOMER][NEUTRAL] Bye bye.
[CUSTOMER][POSITIVE] Thanks. Bye.