AccountId: 011433970860
ContactId: 3889daf0-a278-4567-8e3f-1444a3221e5a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 335029 ms
Total Talk Time (AGENT): 141056 ms
Total Talk Time (CUSTOMER): 81557 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=3.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/10/3889daf0-a278-4567-8e3f-1444a3221e5a_20250610T17:12_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Good afternoon, [PII]. This is [PII] calling from provider's office, checking on claim status.
[AGENT][NEUTRAL] OK, you said that your name is [PII] and first initial to your last name is [PII], is that correct?
[CUSTOMER][NEUTRAL] No, [PII].
[AGENT][NEUTRAL] [PII], is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, thank you and [PII], what is your callback number?
[CUSTOMER][NEUTRAL] Callback number would be [PII] line [PII].
[AGENT][NEUTRAL] OK, thank you, and you're needing claim status, is that correct?
[CUSTOMER][POSITIVE] Yes, perfect.
[AGENT][NEUTRAL] Yes, I can help you with claim status, [PII]. How many claims do you have to check status on?
[CUSTOMER][POSITIVE] Thank you so much for that. I have only one claim for the day.
[AGENT][NEUTRAL] OK, and what is that member's policy number, please?
[CUSTOMER][NEUTRAL] 02295955 M as in Mike L as in Lima 8.
[AGENT][POSITIVE] Thank you. One moment, please.
[AGENT][NEUTRAL] And any information, [PII], that I do provide for you will be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] And the patient's last name would be [PII], [PII]
[CUSTOMER][NEUTRAL] [PII], and the first name as [PII] [PII].
[AGENT][NEUTRAL] OK, so that is not what I show on. What is, what's the last name again?
[CUSTOMER][NEUTRAL] Oh, sure. And the last name would be [PII]
[AGENT][NEUTRAL] OK, so we only, and what is the date of birth?
[CUSTOMER][NEUTRAL] And date of birth would be [PII].
[AGENT][NEUTRAL] OK, so thank you. So we have the name as [PII].
[AGENT][NEUTRAL] That's how the number is listed here at APO.
[CUSTOMER][POSITIVE] Uh thank you so much for that.
[AGENT][NEUTRAL] Mhm. And what is the data service and total bill amount, please?
[CUSTOMER][POSITIVE] Thank you so much for that. The of service would be [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And the total charges would be $542 even.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, so I do show that this claim was received, [PII]. The received date on the claim was [PII].
[AGENT][NEGATIVE] It was processed and denied on [PII].
[AGENT][NEUTRAL] The claim number is 360.
[AGENT][NEUTRAL] 0459.
[AGENT][NEUTRAL] And the reason for the denial states office visits are not covered by the above numbered policy. [PII], the members supplemental plan does not cover office visits, office visits.
[CUSTOMER][POSITIVE] Thank you so much for that information. I appreciated that.
[AGENT][NEUTRAL] And if you
[AGENT][NEUTRAL] Yeah, yes, sir, and if you need a copy of that explanation of then, yes sir, can you print it? Now that you have the claim number, you can go to our portal it's secured. [PII] and you should be able to print that directly from there.
[CUSTOMER][NEUTRAL] Can you please fax it EOB.
[CUSTOMER][POSITIVE] Thank you so much for that information. Can you please provide the hotel link once again?
[AGENT][POSITIVE] Uh, it is secured.
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Thank you so much for that information. Can you please spell your name for me?
[AGENT][NEUTRAL] Yes, sir.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Thank you [PII]. Thank you so much for that. Can I get a call reference number?
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yes, sir, you're gonna use my name along with today's date, [PII].
[AGENT][NEUTRAL] Is there anything else I can help you with?
[CUSTOMER][POSITIVE] Thank you so much for that.
[CUSTOMER][POSITIVE] Thank you so much for the information. You have a great day. Bye for now.
[AGENT][POSITIVE] Well, I hope you have a great day as well and thank you again for calling APL.
[AGENT][NEUTRAL] Bye-bye.