AccountId: 011433970860
ContactId: 4d2e1aef-6ec5-4520-a7db-0a67bad602bf
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 262959 ms
Total Talk Time (AGENT): 102403 ms
Total Talk Time (CUSTOMER): 105712 ms
Interruptions: 2
Overall Sentiment: AGENT=1.3, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/25/4d2e1aef-6ec5-4520-a7db-0a67bad602bf_20250625T12:24_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm calling from provider's office. Thank you call a client status.
[AGENT][NEUTRAL] Surely, I can assist you with that. Can I have a callback number for you and that policy number?
[CUSTOMER][NEUTRAL] Yeah, it's [PII] and the policy number is 0226.
[AGENT][NEUTRAL] Could you repeat the [PII] number again?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] You said [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Thank you. And what's the policy number?
[CUSTOMER][NEUTRAL] It's 022.
[CUSTOMER][NEUTRAL] 62355 M as in Mary, L as in Lima, number 8.
[CUSTOMER][NEUTRAL] And the patient name is [PII].
[CUSTOMER][NEUTRAL] The date of birth is [PII].
[AGENT][NEUTRAL] Thank you, and you're calling to verify benefits and eligibility for what place of service, [PII]?
[CUSTOMER][NEUTRAL] Um, no, I'm checking the client status.
[AGENT][POSITIVE] Oh, my apologies. You're calling to check the status of a claim for what date of service and I'll be able to assist you.
[CUSTOMER][NEUTRAL] It's [PII] with the bill on $468 even.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] You take that for resources on the day the [PII], right?
[AGENT][NEGATIVE] So it looks like this claim was received [PII]. It was processed [PII]. There was no payment made on this claim, and the reason why is because the policy does not cover benefits cover the services provided. Office visits are not covered, nor the treatment received in the office is covered for the policy.
[CUSTOMER][NEUTRAL] Office. Can you repeat again the reason, ma'am? Sorry for that.
[AGENT][NEUTRAL] The disco.
[AGENT][NEUTRAL] There was no payment made on your claim, and the reason why is because services provided are not covered under the policy.
[CUSTOMER][NEUTRAL] Just
[CUSTOMER][NEUTRAL] So it's not covered under the policy.
[AGENT][POSITIVE] Yes, that is correct.
[AGENT][NEUTRAL] Would you like the claim number?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] The claim number is 3596677. That's 3596677.
[CUSTOMER][NEUTRAL] And may I have the claim receive date process date, and the denied date.
[AGENT][NEUTRAL] As stated in the beginning of the call, the claim was received [PII] and it was processed [PII].
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] And the denied date will be also the same [PII], am I right?
[AGENT][POSITIVE] Yes, that is correct.
[AGENT][NEUTRAL] Would you like to verify the effective date of the policy?
[CUSTOMER][POSITIVE] OK, thank you for that and can I please.
[CUSTOMER][NEUTRAL] Um, OK, may I know that?
[AGENT][NEUTRAL] [PII] and it's currently active.
[CUSTOMER][NEUTRAL] Man
[AGENT][NEUTRAL] Is there anything else that I can assist you with today, [PII]?
[CUSTOMER][NEUTRAL] Uh, the [PII]. Am I right?
[AGENT][POSITIVE] Yes, that is correct.
[CUSTOMER][NEUTRAL] OK, may, can you please send the, uh, denyO be through fax? Shall I go the fax number?
[AGENT][NEUTRAL] What is your fax number?
[CUSTOMER][NEUTRAL] 407
[CUSTOMER][NEUTRAL] 745.
[CUSTOMER][NEUTRAL] 0047 with the attention my name as [PII]
[AGENT][NEUTRAL] R as [PII] Romeo.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Is there anything else that I can assist you with today, [PII]?
[CUSTOMER][NEUTRAL] That's it, ma'am. May I know your name and the call reference number for this call?
[AGENT][NEUTRAL] My name is [PII], and today's date is a reference.
[CUSTOMER][POSITIVE] Oh, thank you so much for that information. Have a good day.
[AGENT][POSITIVE] Thanks for calling APO. You have a great one as well. Goodbye.
[CUSTOMER][NEUTRAL] Bye bye.