AccountId: 011433970860
ContactId: 5d6e709b-6e5b-4e1f-a41a-a2766a7db49d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 218279 ms
Total Talk Time (AGENT): 108708 ms
Total Talk Time (CUSTOMER): 52962 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/06/5d6e709b-6e5b-4e1f-a41a-a2766a7db49d_20250206T13:29_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How may I help you today?
[CUSTOMER][NEUTRAL] Uh hi, this is [PII], that is [PII] calling from provider's office to check on claims.
[AGENT][POSITIVE] Alright, she, I'll be glad to help you go ahead with that policy number, please, ma'am.
[CUSTOMER][NEUTRAL] That is 02355946.
[AGENT][NEUTRAL] Alrighty, she, thank you for all that information. Now while I'm pulling this policy number up, go ahead and give me a good return telephone call number please, ma'am.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Um, can you spell your name, please?
[AGENT][NEUTRAL] I sure can. It's [PII] yes. And what is your patient's name and date of birth today?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] All right, thank you for that. She looks like she is the insured on this medical supplemental plan. Now, you did say you want to check status of a claim, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Data service, please, ma'am.
[CUSTOMER][NEUTRAL] Um, sorry?
[AGENT][NEUTRAL] That data service that you're checking on data service.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] $370 even.
[AGENT][NEUTRAL] Alrighty, let's see, [PII]. Looks like that is for an office visit and office visits are not a covered benefit under this medical supplemental plan.
[CUSTOMER][NEUTRAL] Mm, may I know when the claim is received?
[AGENT][NEUTRAL] Yes, ma'am. Let me get over there. Give me just a moment.
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] See.
[AGENT][NEUTRAL] Uh, claim was received on [PII].
[CUSTOMER][NEUTRAL] OK, and the denied on?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, may I know the plan name?
[AGENT][NEUTRAL] Let's see, get over there.
[AGENT][NEUTRAL] What this group name is uh A M O R E S Amo's Dental Care.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Is it dental plan?
[AGENT][NEUTRAL] No, ma'am, that's, that's the employer name that you asked for.
[CUSTOMER][NEUTRAL] OK, uh, claim number? What's the claim number?
[AGENT][NEUTRAL] Claim number 3547318.
[CUSTOMER][NEUTRAL] All right. And the call reference number?
[AGENT][NEUTRAL] We do not give call reference numbers [PII], but you can use my name in today's date and is that all I can help you with?
[CUSTOMER][POSITIVE] Um, nothing. Thank you so much.
[AGENT][POSITIVE] Alrighty, [PII], thank you for calling APL and you have a great rest of your day, OK?
[CUSTOMER][NEUTRAL] Uh, you too, goodbye.
[AGENT][POSITIVE] Thank you, ma'am. Goodbye.