AccountId: 011433970860
ContactId: 4f0959a0-58cc-4f01-8414-b1cbb0d7d43c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 230660 ms
Total Talk Time (AGENT): 66637 ms
Total Talk Time (CUSTOMER): 81608 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/14/4f0959a0-58cc-4f01-8414-b1cbb0d7d43c_20250314T17:15_UTC.wav
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[AGENT][NEUTRAL] Calling APL, my name is [PII]. How can I assist you today?
[CUSTOMER][NEUTRAL] Hi, I'm [PII] calling from NYA to check on the claims. How was your day today?
[AGENT][POSITIVE] I'd be happy to assist with the claim status today, [PII], if I can get a good call back number for you.
[CUSTOMER][NEUTRAL] I'd be
[CUSTOMER][NEUTRAL] Sure, the callback number is [PII].
[AGENT][NEUTRAL] And what is the policy number?
[CUSTOMER][NEUTRAL] Sure. The member ID is 1528892.
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yes, sir. The patient's name is [PII] and the member's date of birth is on [PII].
[CUSTOMER][NEUTRAL] Or
[AGENT][NEUTRAL] OK, and what's the date of service for that claim?
[CUSTOMER][NEUTRAL] Sure, the claim state of service is on [PII] and the charge amount of $688 even. It's $688.
[AGENT][NEUTRAL] OK, I'm showing the claim was denied because there was no active coverage at the time of service.
[CUSTOMER][NEUTRAL] May I get the receipt date for this claim?
[AGENT][NEUTRAL] All right, one moment.
[AGENT][NEUTRAL] Claim was received on [PII]. Claim denied on [PII].
[CUSTOMER][NEUTRAL] One minute.
[CUSTOMER][NEUTRAL] Claim has been denied as no other active coverage for the uh for this patient under the state of service.
[AGENT][NEUTRAL] I'm sorry, repeat that for me.
[CUSTOMER][NEUTRAL] May I get the den? Sorry, may I get the denulation?
[AGENT][NEGATIVE] There was no active coverage.
[AGENT][NEUTRAL] On the data service.
[CUSTOMER][NEUTRAL] OK. May I get the patient's effective and term date?
[AGENT][NEUTRAL] Policy was effective on excuse me, [PII] and the policy lapsed on [PII].
[CUSTOMER][NEUTRAL] Sorry, may I get the patient's effective and term date again? It's [PII].
[AGENT][NEUTRAL] [PII] was the effective date. Policy term, [PII].
[CUSTOMER][NEUTRAL] OK. And may I know does the patient have any other active coverage under the state of service of [PII]?
[AGENT][NEUTRAL] No, there's no other active coverage.
[CUSTOMER][NEUTRAL] OK, thank you. And may I get the claim number?
[AGENT][NEUTRAL] One moment
[AGENT][NEUTRAL] Claim number is 356-9284.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] It's 356-9281, ma'am, right?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] Thank you and may I get the call reference number?
[AGENT][NEUTRAL] Reference is just my name [PII], last initial [PII], and the date and time of the call. Is there anything else I could assist with today?
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] No, I have gotten all the details. Thank you for assisting me and have a nice day.
[AGENT][POSITIVE] Thank you for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] Bye.
[AGENT][NEUTRAL] Bye.