AccountId: 011433970860
ContactId: 40c10845-afc4-4bc0-ae68-6ee740924eed
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 276230 ms
Total Talk Time (AGENT): 117575 ms
Total Talk Time (CUSTOMER): 100408 ms
Interruptions: 4
Overall Sentiment: AGENT=1.6, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/22/40c10845-afc4-4bc0-ae68-6ee740924eed_20250122T13:36_UTC.wav
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[AGENT][POSITIVE] Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Uh, so, my name is [PII].
[AGENT][NEUTRAL] I'm sorry, can you repeat that?
[CUSTOMER][NEUTRAL] Yeah, my name is [PII].
[AGENT][NEUTRAL] Good morning, [PII]. And what is a good callback number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, [PII]. And what is the policy number for the patient?
[CUSTOMER][NEUTRAL] One moment, please. 121 241246.
[AGENT][NEUTRAL] Is that a social because that looks like it has too many numbers for our policy number.
[AGENT][NEUTRAL] You said [PII]?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Do you know if that might be a social?
[CUSTOMER][NEGATIVE] No, it isn't policy right.
[AGENT][NEUTRAL] OK, cause that's too many numbers for the APL policy. What is the patient's last name or do you have a claim number? I can look it up by claim number as well.
[CUSTOMER][NEUTRAL] One moment, please. Uh, the member ID is, uh,
[CUSTOMER][NEUTRAL] 02184704 ML 8.
[AGENT][POSITIVE] Alright, thank you. That is an APL policy number. Thank you for that, [PII].
[AGENT][NEUTRAL] And what is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] The patient name is [PII] and date of birth, [PII].
[AGENT][POSITIVE] All right, thank you. And I do have the policy pulled up. How can I help you today?
[CUSTOMER][NEUTRAL] Yeah, uh, one moment. Uh, last, uh,
[CUSTOMER][NEUTRAL] November 6224, uh, the primary will be sent to you reprocess. Uh, can you check with the reprocess status?
[AGENT][NEUTRAL] And what again was that date of service?
[CUSTOMER][NEUTRAL] I'm just
[CUSTOMER][NEUTRAL] The date of service, [PII] and the amount was $211.
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] Looks like we did receive that on [PII] and processed on [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That's it.
[AGENT][NEUTRAL] The claim was denied because the services were rendered after the policy termed.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The policy termed on 41-2024.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The policy termed on 4-1-2024.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. What we do next?
[AGENT][NEUTRAL] You would need to contact the the patient. There's no further.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Process on our, our side.
[CUSTOMER][NEUTRAL] Yeah, OK. Um, can I send with the patient later?
[AGENT][NEGATIVE] And there's no benefits because the patient was not eligible for benefits for that data service. His policy termed on 4124 and the date of service was [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yeah, OK.
[CUSTOMER][NEUTRAL] Uh, can I get call reference number, please?
[AGENT][NEUTRAL] Call reference number is my name and today's date, and I spell my name [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] And [PII], it was a pleasure to assist you with that claim status. Is there anything else I can help you with today?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] No, no need of you.
[AGENT][POSITIVE] Well, it's been a pleasure to assist you and thank you for calling APL. I hope you have a wonderful day.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Yeah, OK. Thank you.
[AGENT][POSITIVE] Thank you. Bye-bye.
[CUSTOMER][POSITIVE] Have a great day.
[AGENT][NEUTRAL] You too bye bye.
[CUSTOMER][NEUTRAL] OK