AccountId: 011433970860
ContactId: 58498cba-7521-459f-81c4-3d7039733582
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 308279 ms
Total Talk Time (AGENT): 101448 ms
Total Talk Time (CUSTOMER): 80131 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/16/58498cba-7521-459f-81c4-3d7039733582_20250516T13:31_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII]. I'm calling from provider's office to check on claim status. Could you help me with this?
[AGENT][NEUTRAL] For claim status?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, can I get a good call back number in case we get disconnected, [PII]?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And do you have the policy number?
[CUSTOMER][NEUTRAL] I think
[CUSTOMER][NEUTRAL] 02497688.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] Can you verify the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Patient name is [PII].
[CUSTOMER][NEUTRAL] And date of birth is?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you so much.
[AGENT][NEUTRAL] And do you have the date of service?
[CUSTOMER][NEUTRAL] Oh yes. The date of service is [PII].
[CUSTOMER][NEUTRAL] May I know your name, please?
[AGENT][NEUTRAL] My name is [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] You said [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. And what was the total bill amount?
[CUSTOMER][NEUTRAL] $1,136 even.
[CUSTOMER][NEUTRAL] I
[AGENT][POSITIVE] OK, thank you so much.
[AGENT][NEUTRAL] Do you need the claim number?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, it's 358.
[AGENT][NEUTRAL] 3203.
[CUSTOMER][NEUTRAL] OK. When was the claim received?
[AGENT][NEUTRAL] Let me see.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] It looks like we received that claim on [PII], and it was processed on [PII].
[CUSTOMER][NEUTRAL] What is the denial reason?
[AGENT][NEUTRAL] Let me see.
[AGENT][NEGATIVE] It was denied because these services were rendered after coverage was terminated.
[CUSTOMER][NEUTRAL] OK. Could you provide me the policy effective and time please?
[AGENT][NEUTRAL] I'm sorry, could you repeat that?
[CUSTOMER][NEUTRAL] Could you provide me the policy effective and term date?
[AGENT][NEUTRAL] Sure. The effective date for this policy was [PII], and the policy lapsed on [PII]. 0, sorry.
[CUSTOMER][NEUTRAL] Just a moment.
[CUSTOMER][NEUTRAL] OK. The termination date is [PII], correct?
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK. Could you provide me the member has any other insurance?
[CUSTOMER][NEUTRAL] For this date of service?
[AGENT][NEUTRAL] Let me see.
[AGENT][NEUTRAL] No, ma'am. There's no other insurance with us.
[CUSTOMER][NEUTRAL] OK. Could you provide me the call reference number?
[AGENT][NEUTRAL] We don't have a call reference number, but you can use my name in today's date, so [PII], last initial [PII], and today's date.
[CUSTOMER][NEUTRAL] Could you, could you spell your name?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] OK. Thank you for your information. Uh, if I have any other claims, could you provide me the claim status?
[AGENT][POSITIVE] Yes, ma'am, give me one moment to close out this one and I'll be with you in just a second.
[CUSTOMER][NEUTRAL] Uh, just a moment. I will check if I have any other claims or not.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK. Apologies for that. No accounts, no other accounts. Thank you for the information. Have a nice day. Bye for now.
[AGENT][NEUTRAL] There's no other?
[AGENT][POSITIVE] Thank you for calling ATL. Have a great day.
[CUSTOMER][NEUTRAL] Yes, yes. No other.
[CUSTOMER][NEUTRAL] Bye.
[AGENT][NEUTRAL] Bye.
[CUSTOMER][NEUTRAL] Yeah