AccountId: 011433970860
ContactId: 3c065700-265e-4181-8eca-8e9569e3a860
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 363350 ms
Total Talk Time (AGENT): 112085 ms
Total Talk Time (CUSTOMER): 105307 ms
Interruptions: 0
Overall Sentiment: AGENT=1.7, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/04/3c065700-265e-4181-8eca-8e9569e3a860_20250304T17:26_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] Yeah, hi, good morning. This is, uh, uh, [PII]. My last name first initial is [PII] calling from Mother Francis Hospital to check on a claim status.
[AGENT][POSITIVE] OK, well, I'll be more than happy to help you with the claim status, [PII]. And may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure, it's [PII].
[AGENT][NEUTRAL] Thank you for that and the member's policy number?
[CUSTOMER][NEUTRAL] Sure, it's 1086321086322.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Could you please uh spell out your name for me?
[AGENT][NEUTRAL] Sure, my name is [PII].
[CUSTOMER][POSITIVE] Thanks for that.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Sure, ma'am my first name is uh [PII], with the last name of [PII] and date of birth is uh [PII].
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, for some reason, it didn't come up. Hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII]. OK, I have it here and thank you for verifying her information and all the information provided is a verification of benefits, not a guarantee of payment. And may I have the date of service for the claim and the total bill?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Sure, data services [PII]. Total charges.
[CUSTOMER][NEUTRAL] $883 even.
[AGENT][NEUTRAL] Alright, hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And do you mind if I place you on a brief hold while I look for the claim for you?
[CUSTOMER][NEUTRAL] Sure, sure.
[AGENT][NEUTRAL] Alright, hold on one moment.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Hello [PII].
[CUSTOMER][NEUTRAL] Uh, yes.
[AGENT][POSITIVE] Thank you so much for holding. I apologize for that wait. And can you verify the name of the provider's office on the claim?
[CUSTOMER][NEUTRAL] It's a Mother Francis Hospital.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Alright, so I'm sure I received the claim. I'm sorry, what's your tax ID? Because it's coming up as a different provider.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Tax ID.
[CUSTOMER][NEUTRAL] Sure, tax ID [PII].
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] You said [PII]?
[CUSTOMER][NEUTRAL] Uh-huh, yes.
[AGENT][NEUTRAL] OK, it's coming up [PII]. So um sorry about that, but thank you for verifying. I'm showing that we received the claim on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The claim number is 345.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 0081.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And on [PII], the claim was denied?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Because the services were rendered after coverage was terminated?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] This policy was active.
[CUSTOMER][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Uh, sorry, just one moment, please.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, go ahead with the policy affected it.
[AGENT][NEUTRAL] The policy was active from [PII].
[AGENT][NEUTRAL] And there were no other active policies after that.
[CUSTOMER][NEUTRAL] Sorry, uh, could you please confirm the effective date is [PII] and the term on [PII], right?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] No other active coverage for this patient, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Thanks for the information. Uh, could you please help me with the 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][NEUTRAL] Mhm I got it. So could you please double check with the claim number which is 3450081, right?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][POSITIVE] Thank you for that one information. Have a wonderful day, have a wonderful day. Bye for now.
[AGENT][POSITIVE] You also, thanks for calling APO. Bye-bye.
[CUSTOMER][NEUTRAL] Uh bye-bye.