AccountId: 011433970860
ContactId: 4fccc75c-9007-47be-ad10-572f975c0aa7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 254199 ms
Total Talk Time (AGENT): 96131 ms
Total Talk Time (CUSTOMER): 89427 ms
Interruptions: 2
Overall Sentiment: AGENT=1.4, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/23/4fccc75c-9007-47be-ad10-572f975c0aa7_20250123T21:41_UTC.wav
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[AGENT][NEUTRAL] Afternoon, thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, ma'am. Um, I'm calling um in regards to a claim that was submitted, um, back in November. I was calling to check on the claim status.
[AGENT][NEUTRAL] OK, are you calling from the provider's office?
[CUSTOMER][NEUTRAL] Yes I am.
[AGENT][NEUTRAL] OK, yes ma'am, and you're wanting to check claim status for a data service for one of our members, is that correct?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][POSITIVE] Yes, I can help you with that and who am I speaking with, please?
[CUSTOMER][NEUTRAL] Yes, my name is [PII], spelled [PII]
[AGENT][NEUTRAL] Thank you. And [PII], what is your callback number, please?
[CUSTOMER][NEUTRAL] Um, I'll give you my direct line. It's gonna be [PII].
[AGENT][NEUTRAL] Thank you. And the member's policy number, please, Asia.
[CUSTOMER][NEUTRAL] Yes, the member's policy number is um 1 I'm sorry 01989442 M as in Mary, L as in.
[CUSTOMER][NEUTRAL] Lion 7.
[AGENT][POSITIVE] Thank you. One moment please.
[CUSTOMER][POSITIVE] Thank you one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm, sorry about that Asia.
[CUSTOMER][NEUTRAL] Hm.
[AGENT][NEUTRAL] [PII], any information that I do provide for you today would be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] I do like for verification and not a guarantee.
[CUSTOMER][NEUTRAL] The patient's name is [PII], and date of birth is um [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And what is the date of service and total bill amount please?
[CUSTOMER][NEUTRAL] Some
[CUSTOMER][NEUTRAL] Data service is [PII] for um $163.36.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, so excuse me, this claim was received and just one moment, I'll provide you that information.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEGATIVE] This claim was received on [PII] and it was processed and denied on the same day.
[CUSTOMER][NEUTRAL] And it will process in the on the.
[AGENT][NEUTRAL] The claim number is 3,534,160.
[AGENT][NEUTRAL] And the reason for the denial on this claim Asia is office visits are not covered by the above numbered policy.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And if you need a copy of this explanation of benefits, you can go to our portal at [PII] and print that out.
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So, ma'am, can I just um have a reference number for our call as well as the spelling of your name, please? And then that will be all for me.
[AGENT][NEUTRAL] Yes, my name and today's date will be your call reference number. My name is [PII]
[CUSTOMER][POSITIVE] Oh yeah, I appreciate your help today.
[AGENT][POSITIVE] Well, you are certainly welcome, Asia. So if that is all I can help you with, thank you again for calling APL and I hope you have a nice evening.
[CUSTOMER][NEUTRAL] You too. Bye-bye.
[AGENT][POSITIVE] Thank you. Bye-bye.