AccountId: 011433970860
ContactId: 4cb4e90c-f047-4db6-9b0f-f1b50290f04f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 249250 ms
Total Talk Time (AGENT): 97149 ms
Total Talk Time (CUSTOMER): 111572 ms
Interruptions: 1
Overall Sentiment: AGENT=2.4, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/04/4cb4e90c-f047-4db6-9b0f-f1b50290f04f_20250304T19:33_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII] and I am looking for a payment status of a claim.
[AGENT][NEUTRAL] Sure, I can check on a claim for you. I'm sorry, what did you say your name was?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you. Sorry, can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes, my callback number is [PII].
[AGENT][NEUTRAL] OK, thank you. And then do you have the policy number?
[CUSTOMER][NEUTRAL] Members's policy number?
[CUSTOMER][NEUTRAL] Yes, that is 421-355.
[CUSTOMER][NEUTRAL] Hello.
[AGENT][NEUTRAL] OK, and then what was the name and date of birth for the insured please?
[CUSTOMER][NEUTRAL] Yes, um, patient's name is [PII] and the date of birth is [PII].
[AGENT][POSITIVE] Perfect, thank you for verifying that information, [PII]. Uh, do you have the date of service?
[CUSTOMER][NEUTRAL] Yes, I do have a date of service and also a claim number with myself. The date of service.
[AGENT][POSITIVE] Oh perfect, um, um, I could go ahead and just take that claim number that's right.
[CUSTOMER][NEUTRAL] OK. OK. So the claim number is 3555552.
[CUSTOMER][NEUTRAL] For the data service of [PII], ma'am.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Got it. OK, thank you so much for that information, [PII]. One moment please.
[CUSTOMER][POSITIVE] Sure, sure. Take your time.
[AGENT][NEUTRAL] OK. So I am showing for this claim that we were unable to pay a benefit as that is not a covered procedure under this policy.
[CUSTOMER][NEUTRAL] OK. So, could you please give me the uh received date for this claim?
[AGENT][NEUTRAL] Of course one moment.
[AGENT][NEUTRAL] This claim was received [PII].
[AGENT][NEUTRAL] And it was processed [PII].
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] OK, and it has been denied due to not a covered service, right, ma'am?
[AGENT][NEUTRAL] Correct, um, and if you'd like, I can send you a copy of this EOB.
[CUSTOMER][POSITIVE] Yes, I, it will be very.
[CUSTOMER][NEUTRAL] Benefits for me, ma'am if you send me the copy of the COP.
[AGENT][NEUTRAL] Of course.
[AGENT][NEUTRAL] Sure, what was that fax number for you?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] The fax number is.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, I'm going to read that back to make sure I heard that correctly. That was [PII].
[CUSTOMER][NEUTRAL] Sure, sure.
[CUSTOMER][POSITIVE] Perfect, perfect, ma'am.
[AGENT][NEUTRAL] OK, alright, I will get that sent to you and would I just put this to your attention, [PII]?
[CUSTOMER][NEUTRAL] Yes, yes. Please put my name on this attention. And could you please spell out your name for me for this call, ma'am?
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Got you.
[AGENT][NEUTRAL] Sure. Of course, it's [PII]
[AGENT][NEUTRAL] And was there anything else I could help you with?
[CUSTOMER][NEUTRAL] That is
[CUSTOMER][NEUTRAL] [PII]. And what is the reference number for this call, ma'am?
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] Reference number would just be my first name, last initial, and today's date, uh, so my last initial is A.
[CUSTOMER][NEUTRAL] OK, and today's date?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] OK, thank you so much, ma'am and the claim number that I have told you is the right one, right ma'am?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][POSITIVE] OK, OK. Thank you so much, ma'am. Hope you have a great day and thank you for giving me for all the details.
[AGENT][POSITIVE] Of course, you're very welcome.
[AGENT][POSITIVE] Yes ma'am, thanks for calling APL have a great rest of your day.
[CUSTOMER][NEUTRAL] OK, ma'am.
[CUSTOMER][POSITIVE] OK, take care.
[AGENT][POSITIVE] Thank you, bye bye.
[CUSTOMER][NEUTRAL] Bye bye.