AccountId: 011433970860
ContactId: 436e4fe4-3764-46bb-95e8-47af5bfe738c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 291059 ms
Total Talk Time (AGENT): 131203 ms
Total Talk Time (CUSTOMER): 101390 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/21/436e4fe4-3764-46bb-95e8-47af5bfe738c_20250321T13:27_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] OK.
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm calling from office. I want to check the claim status.
[AGENT][POSITIVE] [PII], it would be my pleasure to assist you with claim status. What is the callback number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, [PII]. And what is the policy number, please?
[CUSTOMER][NEUTRAL] 01699646
[AGENT][NEUTRAL] Thank you, [PII]. And what is the policy um patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] Uh, [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you and it would be my pleasure to assist you with that claim status. Do you have a claim number or date of service?
[CUSTOMER][NEUTRAL] No. Yeah, the date of service is [PII].
[CUSTOMER][NEUTRAL] If
[CUSTOMER][NEUTRAL] Get
[CUSTOMER][NEUTRAL] How
[AGENT][NEUTRAL] Now I'm checking [PII]'s policy for [PII].
[AGENT][NEUTRAL] This policy actually turned on 4-1-2024. I'm checking to see if he has active coverage for that data service, if you'll bear with me please.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] I'm checking.
[AGENT][NEUTRAL] [PII], he does have an active policy for that data service. It is under another policy number. Can I provide you the correct policy number?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, as of for [PII], [PII] active policy number is 247.
[AGENT][NEUTRAL] 30.
[AGENT][NEUTRAL] 5.
[CUSTOMER][NEUTRAL] Uh, sorry, uh 24,730.
[AGENT][NEUTRAL] 2473063
[CUSTOMER][NEUTRAL] 63. So is it uh under APL?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It is.
[CUSTOMER][NEUTRAL] OK. So it is active from uh that for uh [PII], right?
[AGENT][POSITIVE] That's correct, and it is current.
[CUSTOMER][NEUTRAL] OK. And what is the claim status for this, uh, like,
[AGENT][NEUTRAL] I'm checking on that.
[CUSTOMER][NEUTRAL] We have built this claim? OK.
[AGENT][NEUTRAL] Sure, and what is the bill amount?
[CUSTOMER][NEUTRAL] OK, it's $245.28.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And what is the facility name?
[CUSTOMER][NEUTRAL] Nicholas Children Pediatrics.
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] [PII], I am showing that we do have that claim on file. It was received on [PII].
[AGENT][NEUTRAL] And it was processed on [PII].
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] This claim was denied as office visits are not covered and that is per the policy guidelines of the patient's plan.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And I can provide that claim number.
[CUSTOMER][NEUTRAL] That's per the guideline, right?
[AGENT][POSITIVE] That's right, of the patient's plan, that is correct.
[CUSTOMER][NEUTRAL] This
[CUSTOMER][NEUTRAL] OK, uh, yeah, could you please provide me the claim number?
[AGENT][NEUTRAL] The claim number is 346.
[CUSTOMER][NEUTRAL] Hello.
[AGENT][NEUTRAL] 556 3.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][POSITIVE] Thank you so much. And what will be the call reference number?
[AGENT][NEUTRAL] Car reference number is my name and today's date. I spell my name [PII]
[AGENT][NEUTRAL] First initial last name [PII].
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK, and today's date, right?
[AGENT][POSITIVE] Yes, sir, that is correct.
[CUSTOMER][POSITIVE] OK, [PII], uh thank you so much for the information that you have provided. That's all for now. Have a nice day.
[AGENT][NEUTRAL] It's
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Well, it has been a pleasure to assist you with that claim status. Thank you for calling APL Kennedy, you have a wonderful day and a happy weekend.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye-bye.