AccountId: 011433970860
ContactId: 39956057-c27c-4232-84ab-40eba39e319f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 263149 ms
Total Talk Time (AGENT): 90095 ms
Total Talk Time (CUSTOMER): 91503 ms
Interruptions: 1
Overall Sentiment: AGENT=1, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/10/39956057-c27c-4232-84ab-40eba39e319f_20250310T20:22_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Good afternoon. Thank you for calling APL. This is.
[CUSTOMER][NEUTRAL] Hey, hi, this is [PII] from University of Miami to check on a claim status.
[AGENT][NEUTRAL] OK, sure. I can assist you with claim status, Mr. [PII]. May I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] It's [PII] is [PII].
[AGENT][NEUTRAL] Thank you. And may I have the patient's policy number, Mr. [PII]?
[CUSTOMER][NEUTRAL] It's 0171359 M as in Mike, L as in Lima, number 7.
[AGENT][NEUTRAL] Can you repeat that number one more time? I think I'm missing one digit.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] It's 01713595. M as in Mike, L as in Lima, number 7.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] The member name is [PII] and the date of birth is uh [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And what is the state of service and the amount of the claim?
[CUSTOMER][NEUTRAL] [PII], total bill amount is $299 even.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] No, it's [PII].
[CUSTOMER][NEUTRAL] to have
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Mm, OK.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] Let me see if there's different.
[CUSTOMER][NEUTRAL] I'm I'm
[CUSTOMER][NEUTRAL] I'm on the and then I letting the.
[AGENT][NEUTRAL] OK, here.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. It looks like we have received the claim on
[CUSTOMER][NEUTRAL] OK looks like we.
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] [PII], processed [PII], and the claim was denied, the denial reason is that the service was rendered after coverage was terminated.
[AGENT][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Yes, uh, may I know the member's policy effective date of coverage?
[AGENT][NEUTRAL] Mhm. Sure.
[CUSTOMER][NEUTRAL] you
[AGENT][NEUTRAL] The policy was effective [PII] and it got terminated [PII].
[CUSTOMER][NEUTRAL] The
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] May I know the claim number?
[AGENT][NEUTRAL] The claim number is 3555959.
[CUSTOMER][POSITIVE] OK. Thank you so much.
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] Is there anything else I can help you with today, Mr. [PII]?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, is there any other coverage for this number?
[AGENT][NEGATIVE] None with us.
[CUSTOMER][NEUTRAL] So you don't know any other policy?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] May I know the conference number?
[AGENT][NEUTRAL] We don't have reference numbers you can use my name in today's name.
[CUSTOMER][NEUTRAL] Could you please spell your name?
[AGENT][NEUTRAL] Sure, that's [PII].
[CUSTOMER][NEUTRAL] And.
[CUSTOMER][POSITIVE] OK, thank you so much.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][POSITIVE] And have a great day. Bye-bye.
[AGENT][POSITIVE] You as well thank you for calling APL. Bye bye, Mr. [PII].