AccountId: 011433970860
ContactId: 4e312538-2564-4480-8ab6-877cd2a32a77
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 189520 ms
Total Talk Time (AGENT): 80986 ms
Total Talk Time (CUSTOMER): 51029 ms
Interruptions: 0
Overall Sentiment: AGENT=1.5, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/23/4e312538-2564-4480-8ab6-877cd2a32a77_20250423T17:22_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Um, hi [PII], I have a question about a, um, denial.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Well, I'll be able to help you with the denial. May I have your name and a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] My name is [PII] and um.
[CUSTOMER][NEUTRAL] My number is [PII].
[AGENT][NEUTRAL] Thank you for that. [PII]. May I have your policy number?
[CUSTOMER][NEUTRAL] 02292692
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And that was 2292692?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Because it's pulling up a different policy.
[CUSTOMER][NEUTRAL] Uh, let me, let me see what's on the denial.
[AGENT][NEUTRAL] Are you calling, are you the insured or you're calling from a provider's office?
[CUSTOMER][NEUTRAL] Provider's office.
[AGENT][NEUTRAL] OK, so what's the insured's first and last name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK. And um her date of birth?
[CUSTOMER][NEUTRAL] Uh [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 either the claim number or the date in service, the date of service and total bill for the claim?
[CUSTOMER][NEUTRAL] The claim number is 358-825-9.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] Alright, so I'm showing the claim was denied requesting an explanation of benefits from primary insurance?
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] What, what do you, who do you show as the primary insurance because they only provided the um APL.
[AGENT][NEUTRAL] Oh, OK, um, so let me make sure this is the correct, um, group number. Hold on one moment.
[AGENT][NEUTRAL] Sometimes it doesn't switch over and I just wanna make sure it doesn't counting.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, yes, so our um policy is second to employee benefit management services. That's what it has listed as the major medical.
[CUSTOMER][NEUTRAL] OK, alright, is there a reference number for the call?
[AGENT][NEUTRAL] There's no call reference number, but you can use my name and today's date, and the first initial to my last name is [PII].
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] You're very welcome. Was there anything else I can assist you with today, [PII]?
[CUSTOMER][NEUTRAL] That's all.
[AGENT][POSITIVE] Alright, thanks for calling APL. I hope you have a great day.
[CUSTOMER][POSITIVE] OK you too bye bye.
[AGENT][POSITIVE] Thank you. Bye bye.