AccountId: 011433970860
ContactId: 5c744ce3-7ff0-412b-9ea2-920b6689bc2b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 248139 ms
Total Talk Time (AGENT): 86630 ms
Total Talk Time (CUSTOMER): 61571 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/12/5c744ce3-7ff0-412b-9ea2-920b6689bc2b_20250312T17:55_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. This is [PII]. I just want to check up on a claim here. Can you help me with that?
[AGENT][POSITIVE] Sure, I'll be more than happy to help you with the claim, and you said your name is [PII]?
[CUSTOMER][POSITIVE] Yes, you're right.
[AGENT][NEUTRAL] OK, and [PII], may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] OK. The good contact number is [PII] and it is a direct line.
[AGENT][NEUTRAL] Thank you for that. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] OK. It will be 024744841.
[AGENT][NEUTRAL] Thank you, can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] OK. The official name is uh [PII], and the date of birth is on number [PII]
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment.
[AGENT][NEUTRAL] And may I have the date of service for the claim you want me to check on?
[CUSTOMER][NEUTRAL] It was [PII]. And the bill amount is $1080 1080.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] And this is for dental or medical?
[CUSTOMER][NEUTRAL] Medical
[AGENT][NEUTRAL] OK, so the medical policy number is 247.
[AGENT][NEUTRAL] 483 7.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] And hold on one moment while I pull that policy.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, so I'm in a new policy now. Hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And there is a there is a claim here for that total bill. Let me find the original.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Here it is.
[CUSTOMER][NEUTRAL] I'm
[AGENT][NEUTRAL] OK, so it looks like the claim was received on [PII].
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] The claim number is 3,488,090.
[AGENT][NEUTRAL] And on August
[AGENT][NEUTRAL] Oh, I said that backwards. On [PII] it was received on [PII], it was processed.
[AGENT][NEGATIVE] And denied because the the um policy does not provide benefits for anesthesia services.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And there's a patient's plan, there is no anesthesia coverage, right?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Thanks for that. And can I get the reference number?
[AGENT][NEUTRAL] Sure, so there's no call reference number, but you can use my name and today's date. The first initial to my last name is [PII].
[CUSTOMER][POSITIVE] Can I get your name once again? Sorry for that.
[AGENT][NEUTRAL] Oh, it's OK. My name is [PII]
[CUSTOMER][POSITIVE] Thank you, [PII]. Have a nice day. Bye for now.
[AGENT][POSITIVE] You're welcome. [PII] and you also, and thanks for calling ATL. Bye-bye.