AccountId: 011433970860
ContactId: 5d9f5a93-15f2-47ce-9720-76f4cd2a02de
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 270390 ms
Total Talk Time (AGENT): 126559 ms
Total Talk Time (CUSTOMER): 118995 ms
Interruptions: 1
Overall Sentiment: AGENT=1, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/17/5d9f5a93-15f2-47ce-9720-76f4cd2a02de_20250217T20:58_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How may I help you today?
[CUSTOMER][NEUTRAL] So.
[CUSTOMER][NEUTRAL] Yeah, hi, I'm [PII] calling from provider's office regarding our claims.
[AGENT][NEUTRAL] I should check the status of a claim. Is that what you said, [PII]?
[CUSTOMER][NEUTRAL] This.
[CUSTOMER][NEUTRAL] I'm sorry.
[CUSTOMER][NEUTRAL] Hello?
[AGENT][POSITIVE] Are you there? Hello, how can I help you?
[CUSTOMER][NEUTRAL] Yeah, actually, uh, I do have a claim for the data service and a bill amount for a particular number. Can you please check and help in the general claim status for this number?
[AGENT][NEUTRAL] Yeah, you want to check the status of a claim. Go ahead, [PII], and give me a policy number.
[CUSTOMER][NEUTRAL] It's 02301203 M as in Mike, L as in Lima.
[CUSTOMER][NEUTRAL] Number 8
[AGENT][POSITIVE] All right, [PII], thank you so much for that information. Now, while I am pulling this up, give me a good return telephone call number, please, sir.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII] with an extension of [PII].
[CUSTOMER][NEUTRAL] So.
[AGENT][NEUTRAL] Alright, thank you for that, [PII]. Now, what is your patient's name, today, and date of birth, please, sir?
[CUSTOMER][NEUTRAL] [PII] first name is uh [PII] and the last name is
[CUSTOMER][NEUTRAL] Male, it's [PII] [PII] and the date of birth is uh [PII].
[AGENT][NEUTRAL] Alrighty, thank you for that information, [PII]. Now you did say you want to check status of a claim, is that correct?
[CUSTOMER][POSITIVE] Yes, you are correct.
[AGENT][NEUTRAL] Data service.
[CUSTOMER][NEUTRAL] Mm. Date of service is uh [PII]. I mean like uh [PII] with the bill of $142 even.
[AGENT][NEUTRAL] Alrighty, let's see, [PII]. I do see a charge of $142 for an office visit. We do have that claim in house. It has been denied due to office visits are not a covered service here.
[CUSTOMER][NEUTRAL] So, I did, uh, like, uh, may I know the member's plan name?
[AGENT][NEUTRAL] You wanna know the plan name as their employer, is that what you're wanting to know?
[CUSTOMER][NEUTRAL] Actually, I need the member's plan name.
[CUSTOMER][NEUTRAL] Is it me or supplementary gap plan?
[AGENT][NEUTRAL] Yes, it is.
[AGENT][NEUTRAL] Yes, this is a medical supplemental plan.
[CUSTOMER][NEUTRAL] Uh, OK, could you please like
[AGENT][NEUTRAL] Through their employer. Mhm.
[CUSTOMER][NEUTRAL] You're sharing that the claim was denied as officers are not covered under the member's policy, am I right?
[AGENT][POSITIVE] That is right.
[CUSTOMER][NEUTRAL] Can you please help me with the claim number and can you send me a copy of your through fax?
[AGENT][NEUTRAL] I sure can. Your claim number is 3490137, and give me a good fax number, [PII].
[CUSTOMER][NEUTRAL] OK, the claim number is 3490137. Am I right?
[AGENT][NEUTRAL] Yes, right.
[CUSTOMER][NEUTRAL] Uh, the callback number is I'm sorry, the fax number is [PII].
[CUSTOMER][NEUTRAL] 777.
[CUSTOMER][NEUTRAL] 3536.
[AGENT][NEUTRAL] Alright, I'm gonna repeat that fax number back, make sure I'm keying this in correctly. That is area code [PII]. Is that correct, [PII]?
[CUSTOMER][NEUTRAL] Yes, right.
[AGENT][NEUTRAL] All right. Give me about 5 minutes and you'll get that fax of an EOB, OK?
[CUSTOMER][NEUTRAL] Sure. Can you spell your name with the last name, please?
[AGENT][NEUTRAL] I sure can. It's [PII] yes, last name initial [PII]
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] [PII], right? is it?
[AGENT][NEUTRAL] Right, [PII].
[CUSTOMER][NEUTRAL] Thank you [PII]. OK, can you please send me a copy of your bill.
[AGENT][POSITIVE] Yes, sir. Thank you.
[AGENT][NEUTRAL] Yes, sir. It will be on the way about 5 minutes then, OK?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] So please thank you [PII]. I will be waiting for the fax.
[AGENT][NEUTRAL] Yes.
[AGENT][POSITIVE] OK, [PII], well, thank you for calling APO and you have a great rest of your day.
[CUSTOMER][POSITIVE] Sure, thank you.
[CUSTOMER][NEUTRAL] You too bye for now.
[AGENT][NEUTRAL] Bye bye.