AccountId: 011433970860
ContactId: 49dc0ba0-6f7a-44db-b5c7-ff3b04bfb263
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 329529 ms
Total Talk Time (AGENT): 82025 ms
Total Talk Time (CUSTOMER): 86142 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/07/49dc0ba0-6f7a-44db-b5c7-ff3b04bfb263_20250507T12:41_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm calling to check on claim status.
[AGENT][POSITIVE] OK, well, 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] I just want
[AGENT][NEUTRAL] Alright, may I have a good contact number in case we're disconnected and the policy number?
[CUSTOMER][NEUTRAL] Callback number is [PII]. And the policy number is X as in X-ray J as in Juliet B as in Bravo, H as in Hotel 1.
[AGENT][NEUTRAL] I'm sorry, can you, can you repeat that slowly, please? I can't hear you.
[CUSTOMER][NEUTRAL] Sorry, that was an incorrect number. One second. Policy number is 01988259 M as in Mike L as in Lima B as in Bravo.
[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] [PII], 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 and the total bills for the claim?
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] A date of service is [PII]. Bill amount is $6460.90.
[AGENT][NEUTRAL] $6460.90.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I have a question.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And what is the question?
[CUSTOMER][NEUTRAL] No question on the claim is the claim was processed and denied, uh, uh, a duplicate initial claim was processed and paid for $437.56 and but the balance, I just wanted to know about the balance.
[AGENT][NEUTRAL] OK, so let me locate the claim and then I can get caught up and I'll be able to answer your question. Hold on one moment, OK?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And you said this claim was paid out on?
[CUSTOMER][NEUTRAL] Yeah, this claim was paid.
[AGENT][NEUTRAL] OK, um, hold on one moment, OK?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Sure.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Hello, [PII].
[CUSTOMER][NEUTRAL] Yes, hello.
[AGENT][POSITIVE] Thank you so much for holding. I apologize for that wait. So, um,
[AGENT][NEUTRAL] I do see the claim where we paid um the $437. So you're wanting to know why only that amount was paid?
[AGENT][NEUTRAL] Is that correct?
[CUSTOMER][NEUTRAL] No, I wanted to know, I wanted to know if there is any denial on the claim.
[AGENT][NEUTRAL] No, there's no denial on the claim.
[CUSTOMER][NEUTRAL] Can I get your name?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Can I get your name?
[AGENT][NEUTRAL] Yes, my name is [PII], first initial to my last name is [PII].
[CUSTOMER][NEUTRAL] Yeah, uh, there's no denial on the claim?
[AGENT][NEUTRAL] Correct, there's no denial on the.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, what would be the reference number?
[AGENT][NEUTRAL] So there's no call reference number, um, you can just use my name in today's date.
[CUSTOMER][POSITIVE] Thank you so much for assisting. Have a nice day.
[AGENT][POSITIVE] You also, and thanks for calling APL. Was there anything else I can assist you with?
[CUSTOMER][POSITIVE] Nothing. Thank you so much for assisting. Have a nice day.
[AGENT][NEUTRAL] You also bye bye.