AccountId: 011433970860
ContactId: 3830e893-ea8d-420f-8ce1-ac69b396856f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 258250 ms
Total Talk Time (AGENT): 135798 ms
Total Talk Time (CUSTOMER): 64267 ms
Interruptions: 1
Overall Sentiment: AGENT=0.3, CUSTOMER=1.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/14/3830e893-ea8d-420f-8ce1-ac69b396856f_20250114T16:22_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, yes, I'm calling from a provider's office. I was calling to check general claim status for one claim, please.
[AGENT][NEUTRAL] OK, sure, I can assist you with claims. May I have your name?
[CUSTOMER][NEUTRAL] Yes, my name is [PII].
[AGENT][NEUTRAL] Miss [PII], may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Sure it's [PII].
[AGENT][NEUTRAL] Thank you and may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Uh, yes, for this one I have, um, not sure if this is it, but I have 02148442 for a [PII] fortune or fortune.
[AGENT][NEUTRAL] OK. What's her date of birth?
[CUSTOMER][NEUTRAL] It's uh [PII].
[AGENT][NEUTRAL] OK perfect thank you and what is the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Uh, this is uh 3-11-2024 and it's uh bill for $1,944.
[AGENT][NEUTRAL] OK, let me see if I can find this claim for you. And for future, you can check claim status online through our website at [PII] and that's just optional.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] And
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And this is for medical, correct?
[CUSTOMER][NEUTRAL] Yes, medical.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] All right. So it looks like we received the claim on [PII].
[AGENT][NEUTRAL] And we process the.
[AGENT][NEUTRAL] On the [PII].
[AGENT][NEUTRAL] And
[CUSTOMER][NEUTRAL] Uh, is it [PII]?
[AGENT][NEUTRAL] Let me see, [PII], bear with me.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEGATIVE] Saying it was received on the [PII] and processed on the [PII], that doesn't quite match.
[AGENT][NEUTRAL] Let me see if this is a 2nd.
[AGENT][NEUTRAL] Let me pull the image. I'm sorry, one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, makes a lot more sense. OK, so it was received on [PII].
[AGENT][NEUTRAL] And it was processed for the first time on [PII].
[AGENT][NEUTRAL] Uh, we were waiting for eligibility and then it was processed again on [PII]. So the last time that it was processed was [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEGATIVE] And um the claim was denied. The reason for this denial is that our records indicate that the premium for the date of service was not received, therefore benefits are not payable. The policy end up terminating.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, is there a term date?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Termination date is [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Got it. Alright, OK, I think that was all I needed then I'll just take a reference number. Thank you for your help.
[AGENT][NEUTRAL] You're welcome. We don't have reference numbers. You can use my name in today's state if you would like this. [PII], do you need the spelling of my name or any other information?
[CUSTOMER][NEUTRAL] Uh, sure, I can take the spelling of your name.
[AGENT][NEUTRAL] OK, sure. That's [PII]. Last initial is [PII].
[CUSTOMER][POSITIVE] OK, I actually have that spelled right, got it.
[AGENT][NEUTRAL] Yeah, but you.
[CUSTOMER][POSITIVE] OK, that was all I needed. Thank you so much for your help.
[AGENT][POSITIVE] You're welcome, Ms. [PII] and thank you for calling APL. Have a good day.
[CUSTOMER][POSITIVE] All right. You too. Take care. Bye.
[AGENT][POSITIVE] Thank you. You too, bye.