AccountId: 011433970860
ContactId: 5b9d2c18-bf0a-4805-b55e-43e1799dbb7a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 171539 ms
Total Talk Time (AGENT): 65881 ms
Total Talk Time (CUSTOMER): 74002 ms
Interruptions: 0
Overall Sentiment: AGENT=1.6, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/08/5b9d2c18-bf0a-4805-b55e-43e1799dbb7a_20250108T18:27_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, yes, um, I'm calling because, um, I have a policy with you guys and I got a bill from my gynecologist advising that they sent you guys the bill and you guys said that you guys don't cover that, and I kinda wanted to get a little bit more information.
[AGENT][NEUTRAL] OK, sure, I can assist you with claims. And may I have the policy number?
[CUSTOMER][NEUTRAL] Um, so,
[CUSTOMER][NEUTRAL] I have the group number and then I have an in hospital and outpatient benefit cert number.
[AGENT][NEUTRAL] Outpatient cert.
[CUSTOMER][NEUTRAL] Um, so it would be 02449716 ML 8.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] May I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[AGENT][NEUTRAL] Thank you and may I have your name and date of birth for security?
[CUSTOMER][NEUTRAL] Yes, [PII]. Date of birth is [PII].
[AGENT][POSITIVE] OK perfect thank you and what is the um date of service?
[CUSTOMER][NEUTRAL] Um, it appears [PII].
[AGENT][NEUTRAL] OK, and I also need to verify the mailing address, email address on file.
[CUSTOMER][NEUTRAL] Um, my mailing address is [PII].
[CUSTOMER][NEUTRAL] And then my email is [PII].
[AGENT][POSITIVE] Perfect thank you.
[CUSTOMER][NEUTRAL] Unless you have my work one.
[AGENT][NEUTRAL] No, that's the one we have. Thank you. Alright, so that's [PII].
[AGENT][NEUTRAL] OK, was it for an office visit?
[CUSTOMER][NEUTRAL] Um, so, yeah, I had an ultrasound, if I'm not mistaken, [PII], as I was being tested for polycystic ovaries.
[AGENT][NEUTRAL] OK. All right. So it looks like they only send us the claim for the office visit. Um, they did not send us the claim for the procedure. So this was just the office visit and that's why we denied the claim.
[CUSTOMER][NEUTRAL] Got it. OK, understood. um, I'll call them back then and, and confirm with them then.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, is there anything else I'm gonna help you with today?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] No, that is all. Thank you so much.
[AGENT][POSITIVE] You're welcome and thank you for calling APL. You have a good afternoon.
[CUSTOMER][POSITIVE] Thank, thank you.
[AGENT][POSITIVE] Thank you.