AccountId: 011433970860
ContactId: 59468c4f-9ac6-4e4a-93ce-a26cdd250653
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 238130 ms
Total Talk Time (AGENT): 118318 ms
Total Talk Time (CUSTOMER): 51723 ms
Interruptions: 1
Overall Sentiment: AGENT=3, CUSTOMER=2.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/28/59468c4f-9ac6-4e4a-93ce-a26cdd250653_20250228T15:29_UTC.wav
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[AGENT][NEUTRAL] Hi, thank you for calling APL. This is [PII]. How can I help you today?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I'm calling from Atrium Health. I need to check claim status, please.
[AGENT][POSITIVE] OK, Ms. [PII], I'd love to help you with claim status today. Do you mind if I snag that um callback number real quick from you?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you and what is the policy number we wanna look at today?
[CUSTOMER][NEUTRAL] It is 02512075.
[AGENT][POSITIVE] Perfect, give me just a moment to get that pulled up for you.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You having a great day today?
[CUSTOMER][POSITIVE] Yes, it'll be even better in about 30 minutes. I leave at [PII] on Friday.
[AGENT][POSITIVE] Oh, that is nice. OK, I'm very glad to hear that. Well, let's get you taking care of my friend, and
[AGENT][NEUTRAL] Just one more second.
[AGENT][NEUTRAL] Would you be able to verify for me pretty please your member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Sure, it is [PII]. Date of birth is [PII].
[AGENT][POSITIVE] Perfect, I do see that here and what is the date of service for [PII] we wanna look at today?
[CUSTOMER][NEUTRAL] [PII] through 828 2024.
[AGENT][POSITIVE] OK, perfect. And the total bill amount?
[CUSTOMER][NEUTRAL] $6,543.15.
[AGENT][NEUTRAL] 6,543 and you said 15 or 16 cents?
[CUSTOMER][NEUTRAL] 15
[AGENT][NEUTRAL] 15. OK. Let me check something for you.
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] Would you be able to verify for me pretty please the, oh, you said the name of the facility was Atrium Health, never mind. I'm sorry, you already did verify. Thank you.
[CUSTOMER][NEUTRAL] Yes
[AGENT][NEUTRAL] Um,
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] I see your claim here. It looks like we received this claim on [PII]. I have your claim number listed as 3513034, and the claim is processed on 10-14-2024. I do show that that claim denied, and I have your denial code listed as um.
[AGENT][NEUTRAL] Um, not eligible for benefits. Our records indicate that premium for the service date was not received. Therefore, benefits are not payable, um, and I actually do show that his policy terminated on [PII] or [PII].
[CUSTOMER][NEUTRAL] Uh-huh, that makes sense.
[CUSTOMER][POSITIVE] Alrighty, thank you so much. I appreciate your help.
[AGENT][POSITIVE] Yeah, it's my pleasure, Ms. [PII]. I hope you have a fabulous last 30 minutes and you enjoy this. I don't know if the weather's nice where you are, but it's sunny and gorgeous where I am. So I hope you enjoy it.
[CUSTOMER][POSITIVE] It is funny here right now too, so thank you very much and I hope you have a good weekend as well.
[AGENT][POSITIVE] Good.
[AGENT][POSITIVE] You too take care thanks for calling APL bye bye.
[CUSTOMER][NEUTRAL] Uh huh bye bye.