AccountId: 011433970860
ContactId: 3c615f7b-2a62-4f05-addf-fd24f1281f54
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 318049 ms
Total Talk Time (AGENT): 124528 ms
Total Talk Time (CUSTOMER): 87391 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/03/3c615f7b-2a62-4f05-addf-fd24f1281f54_20250103T15:34_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yeah, hi, [PII]. My name is [PII]. I'm calling from Do office. I'm looking for claim status on another patient here. Could you help me for that?
[AGENT][NEUTRAL] Hi.
[AGENT][POSITIVE] OK, I'll be more than happy to help you with the claim status, [PII], and how many claims do you have in total today?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] This one.
[AGENT][NEUTRAL] Alright, and may I have a good contact number in case we're disconnected and the policy number?
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] It's [PII]. It's a direct line?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And the policy number whenever you're ready.
[CUSTOMER][NEUTRAL] 01632235
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Yeah, sure.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, OK.
[CUSTOMER][NEUTRAL] It's [PII]. and date of birth is [PII].
[AGENT][NEUTRAL] Thank you for that 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 you like me to check on?
[CUSTOMER][NEUTRAL] 87 2024.
[CUSTOMER][NEUTRAL] The total bill amount is $7,192.33.
[AGENT][NEUTRAL] Thank you. Hold on one moment. Again, just for the call, all the information provided is a verification of benefits, not a guarantee of payment. Hold on one moment while I locate your claim.
[AGENT][NEUTRAL] And what is the name of the provider's office on your claim?
[CUSTOMER][NEUTRAL] Uh, sure. It's Western Oklahoma Pain Specialist.
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] And Terrence, is it alright if I place you on just a brief hold while I locate the claim?
[CUSTOMER][NEUTRAL] Yeah, sure, go ahead.
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Wait, so this is the only one? What happened? I thought it was a whole bunch.
[AGENT][NEUTRAL] Oh no, it's just OK then.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I had it right. I thought it was more than that.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Just to be on the safe side, yeah, OK.
[AGENT][NEUTRAL] Hello [PII].
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] Thank you so much for holding. I apologize for that wait. So I'm showing we received the claim on [PII].
[AGENT][NEUTRAL] And that claim number is 351.
[AGENT][NEUTRAL] 7993.
[CUSTOMER][NEUTRAL] OK.
[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] OK.
[AGENT][NEUTRAL] This policy was active from [PII].
[CUSTOMER][NEUTRAL] Uh, [PII]. Uh-huh. OK.
[AGENT][NEUTRAL] Of [PII].
[CUSTOMER][NEUTRAL] So there's no longer active, right after that?
[AGENT][NEUTRAL] Right, and there's no other active policies with APL.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] So just a moment.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, well, I
[CUSTOMER][NEUTRAL] I
[CUSTOMER][POSITIVE] OK, great. I got it. Thank you for the information. I appreciate that. Um, I need a copy of your before this one. Could you to send to my fax number?
[AGENT][NEUTRAL] Sure, what's a good fax number for you?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And do I need to put attention, [PII]?
[CUSTOMER][POSITIVE] That's correct.
[AGENT][NEUTRAL] And that's [PII]?
[CUSTOMER][POSITIVE] Yeah, that's correct.
[AGENT][NEUTRAL] All right, well, I'll go ahead and fax this over to you now. Was there anything else I could assist you with today?
[CUSTOMER][NEUTRAL] What
[CUSTOMER][POSITIVE] Uh thank you. What's your name and sur sorry for that.
[AGENT][NEUTRAL] Oh, it's OK. My name is [PII].
[CUSTOMER][NEUTRAL] OK, um, can have a reference number for that now?
[AGENT][NEUTRAL] Um, so there's no call reference number, but you can use my name in today's date.
[CUSTOMER][POSITIVE] Yeah, OK, I got it. Thank you very much, [PII]. I really appreciate that you that information, OK.
[AGENT][POSITIVE] You're very welcome. Was there anything else I could assist you with today?
[CUSTOMER][POSITIVE] I think I got it. Thank you for the information.
[AGENT][POSITIVE] You're welcome. Thanks for calling APL. Bye-bye.
[CUSTOMER][POSITIVE] Yeah, have a wonderful day. Bye-bye.