AccountId: 011433970860
ContactId: 5c098ab0-4346-4b98-81d2-d5da33a4a99d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 547270 ms
Total Talk Time (AGENT): 187545 ms
Total Talk Time (CUSTOMER): 155266 ms
Interruptions: 2
Overall Sentiment: AGENT=0.3, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/21/5c098ab0-4346-4b98-81d2-d5da33a4a99d_20250421T21:01_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from providers shop.
[CUSTOMER][NEUTRAL] Uh, regarding the premium.
[CUSTOMER][NEUTRAL] Information. So could you please provide me?
[AGENT][NEUTRAL] I can hardly hear you. Can you repeat that information?
[CUSTOMER][NEUTRAL] Uh, hi. This is [PII] calling from provider's office regarding the premium information. So could you please provide me that?
[AGENT][NEUTRAL] Are you trying to get claim information or premium information?
[CUSTOMER][NEUTRAL] Female information.
[AGENT][NEUTRAL] So you're calling from a group.
[CUSTOMER][NEUTRAL] Sorry.
[AGENT][NEUTRAL] Let me have the spelling of your name. I can hardly hear you that connection.
[AGENT][NEUTRAL] May I have your name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII]. OK. Yeah. You sound really far away from that phone. OK. Miss [PII], um, what's the name of the facility you're calling from?
[CUSTOMER][NEUTRAL] That is the Central Illinois Radiological Associates.
[AGENT][NEUTRAL] OK, and what is the callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, you need to repeat that one more time, please.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK. May I have the patient's policy number?
[CUSTOMER][NEUTRAL] 02392261.
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Last name is [PII] and date of birth is
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] What is the date of service?
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] And [PII] for the bill amount $58 even.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And that was [PII].
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. Miss [PII], this policy has been terminated, and that's the reason for that denial.
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] The policy was terminated.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] And that's the reason for the denial.
[CUSTOMER][NEUTRAL] OK, the policy has been terminated.
[AGENT][NEUTRAL] So the service was rendered after coverage was terminated.
[CUSTOMER][NEUTRAL] OK. That is non-covered, right?
[AGENT][NEUTRAL] The, the policy was terminated.
[CUSTOMER][NEUTRAL] OK, uh, may I have the
[CUSTOMER][NEUTRAL] Color for this one.
[AGENT][NEUTRAL] You need what information, Miss [PII]?
[CUSTOMER][NEUTRAL] Call reference number?
[AGENT][NEUTRAL] OK. Um, do you need the termination date of the policy?
[CUSTOMER][NEUTRAL] I have a
[CUSTOMER][NEUTRAL] Yeah, uh, I have one more patient with the same provider. Could you please provide me the status of that one also?
[AGENT][NEUTRAL] Yeah, I can provide you with the status, but you don't need any other information on this one, Ms. [PII]? Do you need the claim number? Do you need the uh termination date? Do you don't need any information on this one?
[CUSTOMER][NEUTRAL] The same reason.
[CUSTOMER][NEUTRAL] Yeah, the claim number, sorry.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Go. Thank you for reminding me.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] OK, the claim number is 3555795.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, and the termination date.
[AGENT][NEUTRAL] Termination date is let's see.
[AGENT][NEUTRAL] This [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] It's gonna be [PII].
[CUSTOMER][NEUTRAL] OK, um,
[CUSTOMER][POSITIVE] Now you can provide me uh the color of this.
[AGENT][NEUTRAL] We don't have reference numbers, you can use my name and today's date.
[CUSTOMER][NEUTRAL] Uh, can you please spell out your name?
[AGENT][NEUTRAL] You say, can I spell out my name? Is that what you said?
[CUSTOMER][NEUTRAL] Uh yes, yes.
[AGENT][NEUTRAL] OK, that's [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Is there anything else I can help you with today?
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][POSITIVE] Um, OK, thank you.
[CUSTOMER][NEUTRAL] Yeah, uh, the same provider.
[CUSTOMER][NEUTRAL] The different patients, patients, different.
[AGENT][NEUTRAL] What's the policy number?
[CUSTOMER][NEUTRAL] 02392361.
[AGENT][NEUTRAL] What's the name and date of birth?
[CUSTOMER][NEUTRAL] The same, uh, [PII].
[AGENT][NEUTRAL] Um, I pull a different member. What is the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Date of birth.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] What are you giving me?
[CUSTOMER][NEUTRAL] And uh uh sorry, uh, this was at a different doors date of service.
[AGENT][NEUTRAL] OK. Uh, I'm, I'm having a lot of troubles hearing you, Ms. [PII]. I'm not sure if you're far from the phone or your volume is really low, or I'm not sure what's going on, but um I, I'm having really troubles hearing, hearing you. Um, the policy number that you gave me, is it the same policy number as prior or is it a different policy number?
[CUSTOMER][NEUTRAL] That is [PII].
[CUSTOMER][NEUTRAL] I don't
[CUSTOMER][NEUTRAL] Yeah, that was the same.
[AGENT][NEUTRAL] The same policy number.
[CUSTOMER][NEUTRAL] As prior
[AGENT][NEUTRAL] OK. So it's the same policy number, it's just a different date of service.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, what is the date of service?
[CUSTOMER][NEUTRAL] That is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] For the bill amount 60.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] The bill amount is $64 each.
[AGENT][NEUTRAL] OK, so [PII] for $64 even.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] OK.
[AGENT][NEGATIVE] OK, so this one is the same denial. The, the service was rendered after the coverage was terminated.
[CUSTOMER][NEUTRAL] OK, uh, may I have the claim number for this one?
[AGENT][NEUTRAL] Yes, the claim number is 3555.
[AGENT][NEUTRAL] 788.
[CUSTOMER][NEUTRAL] And the termination date?
[AGENT][NEUTRAL] It's the same termination date as the prior one.
[CUSTOMER][NEUTRAL] Hm
[CUSTOMER][NEUTRAL] The color reference number would be the same.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] Thank you so much for the information.
[AGENT][POSITIVE] You're welcome. Is there anything else I may help you with today?
[CUSTOMER][POSITIVE] Oh no, that's all. Thank you so much.
[AGENT][POSITIVE] OK. You're welcome. Thank you for calling APL. Have a good day. Bye-bye.
[CUSTOMER][NEUTRAL] OK