AccountId: 011433970860
ContactId: 4ba7404a-75bc-4df5-afbc-d47402e53405
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 212899 ms
Total Talk Time (AGENT): 70615 ms
Total Talk Time (CUSTOMER): 91446 ms
Interruptions: 0
Overall Sentiment: AGENT=3.8, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/15/4ba7404a-75bc-4df5-afbc-d47402e53405_20250115T19:35_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Um, hi, sir. I would like to check if you have received, um, a claim.
[AGENT][POSITIVE] OK, I'm happy to.
[CUSTOMER][NEUTRAL] Or if there is a claim on file?
[AGENT][POSITIVE] OK, I'm happy to check on a claim for you. What is the policy number?
[CUSTOMER][NEUTRAL] Policy number is
[CUSTOMER][NEUTRAL] 01
[CUSTOMER][NEUTRAL] 869-072 M for Mary, L for Lima, number 8.
[AGENT][POSITIVE] Thank you so much and then if I could get your first name and a callback number?
[CUSTOMER][NEUTRAL] Uh, my name is [PII]. My direct number is [PII].
[AGENT][POSITIVE] Thank you so much. And then may I please have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Uh, [PII], spelled as [PII] Date of birth, [PII].
[AGENT][POSITIVE] Thank you so much. And then what is the date of service?
[CUSTOMER][NEUTRAL] Uh, date of service is [PII], bill amount 273.
[AGENT][POSITIVE] Thank you. One moment.
[CUSTOMER][POSITIVE] Mhm. Thank you.
[AGENT][NEUTRAL] All right, so it looks like we did receive this claim, uh, the claim it looks like was received on.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] Claim was denied offices are not covered under the member's policy.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. Office visit is not.
[CUSTOMER][NEUTRAL] Covered.
[CUSTOMER][NEUTRAL] 10.
[CUSTOMER][NEUTRAL] Oh I see, so it is patient responsibility.
[CUSTOMER][NEUTRAL] I see. OK. And I just need a reference number, ma'am. Thank you.
[AGENT][NEUTRAL] OK, absolutely. Call reference is going to be my name with my last initial then today's date. Uh that's again [PII], last initial [PII], and then today's date.
[CUSTOMER][NEUTRAL] OK. And then, can you please
[CUSTOMER][NEUTRAL] Send us the copy of the explanation of benefits.
[AGENT][POSITIVE] Mhm, absolutely. What is a good fax number?
[CUSTOMER][NEUTRAL] OK. Uh, please send it to fax number [PII] and put an attention to my name, [PII].
[AGENT][NEUTRAL] All right, [PII], so I am sending that fax now. Should be there in about 5 minutes. Is there anything else I can help with today?
[CUSTOMER][NEUTRAL] OK, so let's see.
[CUSTOMER][POSITIVE] OK. Yes, that's all I needed for now. Thank you so much for your help today, [PII].
[AGENT][POSITIVE] You're welcome. Have a good day.
[CUSTOMER][POSITIVE] Thank you. Bye.
[AGENT][NEUTRAL] Bye bye.