AccountId: 011433970860
ContactId: 5a31670d-f78c-4133-8615-2cf094f9c619
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 305649 ms
Total Talk Time (AGENT): 78783 ms
Total Talk Time (CUSTOMER): 65819 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/07/5a31670d-f78c-4133-8615-2cf094f9c619_20250407T14:48_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII] and I need to check on the claim. Can you please help me on this?
[AGENT][NEUTRAL] Uh, yes, I'm happy to check on a claim today, [PII]. What's the patient's policy number?
[CUSTOMER][NEUTRAL] Yes, sure, just a moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 1016.
[CUSTOMER][NEUTRAL] 857-49.
[AGENT][NEUTRAL] All right, let me pull this up here one moment.
[AGENT][NEUTRAL] And do you have a good call back number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And patient's name and date of birth?
[CUSTOMER][NEUTRAL] Uh-huh, yes sir, that's all.
[CUSTOMER][NEUTRAL] Uh, once again.
[CUSTOMER][NEUTRAL] Patient name is [PII], [PII].
[AGENT][NEUTRAL] OK, and what's the data service?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the build out?
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] Mm $104 even.
[AGENT][NEUTRAL] Do you have an amount after the primary paid?
[CUSTOMER][NEUTRAL] No, um.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Do you have any claim on file?
[AGENT][NEUTRAL] No claim on file for that build amount and data service.
[CUSTOMER][NEUTRAL] OK, just a moment.
[CUSTOMER][NEUTRAL] What is the patient effective date?
[AGENT][NEUTRAL] Uh, policy effective date is [PII]. Patients still active.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Are you ready?
[AGENT][NEUTRAL] 60801.
[CUSTOMER][NEUTRAL] 608
[AGENT][NEUTRAL] 01
[CUSTOMER][NEUTRAL] OK. And your name?
[AGENT][NEUTRAL] My name is [PII].
[CUSTOMER][NEUTRAL] OK. Uh, what is the reference number for this particular call?
[AGENT][NEUTRAL] The call reference is my name with my last initial and then today's date. The last initial to my name is [PII].
[CUSTOMER][NEUTRAL] OK. Shall I proceed next to member ID?
[AGENT][NEUTRAL] Uh, if you have another one, [PII], give me just a moment. I need to notate this and we can check on the next one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] OK, I'm ready for the next policy number when you are.
[CUSTOMER][NEUTRAL] 024
[CUSTOMER][NEUTRAL] 46538.
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] ID [PII], [PII], date of birth.
[AGENT][NEUTRAL] OK. And date of service?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Total bill amount $277 even.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] Alright. We received a claim for the state of service on [PII].
[AGENT][NEUTRAL] Claim was denied on [PII].
[AGENT][NEUTRAL] Office visits are not covered under the member's policy.
[CUSTOMER][NEUTRAL] With the UOBS we generated?
[AGENT][NEUTRAL] I'm sorry, what was that?
[CUSTOMER][NEUTRAL] No.