AccountId: 011433970860
ContactId: 55db730a-647a-423e-9968-ca51c1e7fc67
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 272929 ms
Total Talk Time (AGENT): 90241 ms
Total Talk Time (CUSTOMER): 57352 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=-0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/27/55db730a-647a-423e-9968-ca51c1e7fc67_20250327T18:51_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] My name is [PII]. I'm calling from a provider office checking claim status.
[AGENT][POSITIVE] OK, well, I'll be more than happy to help you with the claim status, and may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you for that. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] 022
[CUSTOMER][NEUTRAL] 18491, M as in Mike, L as in Lima, number 8.
[AGENT][NEUTRAL] OK, can you repeat the policy number? I'm sorry, it didn't save.
[CUSTOMER][NEUTRAL] 022
[CUSTOMER][NEUTRAL] 18491, M as in Mike, L as in Lima, number 8.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] Can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] [PII] [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 the date of service for the claim and the total bill?
[CUSTOMER][NEUTRAL] [PII] last year, $1,386 even.
[AGENT][NEUTRAL] OK, for [PII], there's no claim on file for [PII].
[CUSTOMER][NEUTRAL] 1312132024.
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Can you verify the name of the provider's office on the claim?
[CUSTOMER][NEUTRAL] Yeah. Pain relief solutions.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] So I'm trying to receive the claim on [PII].
[AGENT][NEUTRAL] The claim number is 3558619.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And on [PII], the claim was denied?
[AGENT][NEUTRAL] Hold on one moment, the denial reason is populating.
[AGENT][NEUTRAL] And do you mind if I place you on just a brief hold?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, hold on one moment.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you so much for holding, [PII]. I apologize for that wait. So the services were rendered after coverage was terminated. The policy was active.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] From [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So, after [PII], is there any other coverage from for this member?
[AGENT][NEUTRAL] Not with APL. Um, if they do have it, I'm unsure of what it is. You'll have to reach out to the member.
[CUSTOMER][NEUTRAL] OK, call reference.
[AGENT][NEUTRAL] There's no call reference number, but you can use my name and today's date. The first initial to my last name is [PII].