AccountId: 011433970860
ContactId: 51addfcf-5868-48b1-a0af-1c9cabbd5e4b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 231190 ms
Total Talk Time (AGENT): 84088 ms
Total Talk Time (CUSTOMER): 82082 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/23/51addfcf-5868-48b1-a0af-1c9cabbd5e4b_20250123T15:33_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], um, I'm calling in regards to a claim that we had sent over and I was looking to see if I could get an update.
[AGENT][NEUTRAL] OK, so you're just checking on the status of the claim?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] And may I ask who I'm speaking with?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] And [PII], in case this call is disconnected, may I have your callback number?
[CUSTOMER][NEUTRAL] Of course my direct line is [PII].
[AGENT][NEUTRAL] Thank you and may I have your policy number?
[CUSTOMER][NEUTRAL] Yes, it looks like the policy number is 0255995.
[AGENT][NEUTRAL] OK. Can you please repeat that cause you were cutting out.
[CUSTOMER][NEUTRAL] Oh, I apologize, it's 02559195.
[AGENT][NEUTRAL] Thank you, and it was 255-919-5?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And you're calling from the provider's office?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, and [PII], may I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Of course. First name is [PII], last name [PII].
[CUSTOMER][NEUTRAL] And date of birth is [PII].
[AGENT][NEUTRAL] Thank you and may I have the date of service and bill amount of the claim?
[CUSTOMER][NEUTRAL] Date of service will be [PII] and billed amount is 447 even.
[AGENT][NEUTRAL] Thank you. So that data service is [PII] for $447.
[CUSTOMER][POSITIVE] Correct.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] So I show we did receive that claim in on [PII]. It was processed on [PII] on that claim, and benefits under the policy certificate are limited to those outlined under the schedule of benefits. This is not a covered loss under the plan. Therefore, no benefits were payable. Would you like the claim number?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] The number is 35.
[AGENT][NEUTRAL] 43288.
[CUSTOMER][NEUTRAL] OK perfect and I'm not showing that we had received that response quite yet. Is there any way you would be able to fax me the explanation of benefits for this state of service?
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] Sure, we can fax it to you. What's your fax?
[CUSTOMER][NEUTRAL] Um, it'll be the same as my direct line, so [PII].
[AGENT][NEUTRAL] OK, and can I get the spelling of your name? Do I just need to make it to your attention?
[CUSTOMER][NEUTRAL] Um, that'll come directly to me, but my name again is [PII] and my last initial is [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, I will get that faxed over to you, [PII]. Is there anything else I can assist you with today?
[CUSTOMER][POSITIVE] I think that'll be all for now. Thank you so much for your help today, [PII].
[AGENT][POSITIVE] You're welcome. Thanks for calling APO. You have a good day.
[CUSTOMER][NEUTRAL] You as well.
[AGENT][POSITIVE] Thanks bye.
[CUSTOMER][NEUTRAL] Bye-bye.