AccountId: 011433970860
ContactId: 5e7e3252-4bd2-4848-8995-15ac0ef9f9e5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 171190 ms
Total Talk Time (AGENT): 69207 ms
Total Talk Time (CUSTOMER): 71729 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/20/5e7e3252-4bd2-4848-8995-15ac0ef9f9e5_20250220T21:42_UTC.wav
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[AGENT][NEUTRAL] Afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII]. I'm calling for a provider office to check on additional information about a claim that has been denied. Please know this call will be monitored and recorded for quality and training purposes. Can you spell your name, please?
[AGENT][NEUTRAL] Yes, ma'am. My name is [PII].
[AGENT][NEUTRAL] And [PII], what is a good callback number, please?
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] [PII]. It's a direct line.
[AGENT][POSITIVE] Thank you, [PII]. And do you have that claim number? It would be a pleasure to assist you with that claim information.
[CUSTOMER][NEUTRAL] Uh, sure, one moment.
[CUSTOMER][NEUTRAL] Yes, thanks for waiting claim number it is 3,558,320.
[AGENT][NEUTRAL] And what is the patient's name and date of birth, please, ma'am?
[CUSTOMER][NEUTRAL] [PII], date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And can you verify the date of service and.
[AGENT][NEUTRAL] Buil amount for the claim and facility name.
[CUSTOMER][NEUTRAL] Sure. Uh, data service [PII] bill amount $239 even and the facility name, it is Inside Medical Solution INC.
[AGENT][NEUTRAL] Thank you, [PII]. [PII], I am showing that this policy was denied because the services were rendered after the policy termed. [PII]'s policy turned on [PII].
[CUSTOMER][NEUTRAL] Uh sorry, what is the effective date?
[AGENT][NEUTRAL] Effective date is [PII], and the policy turned on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]. Does the member has any other active insurance?
[AGENT][NEGATIVE] Not with our company.
[CUSTOMER][NEUTRAL] So, uh just to confirm, the member is not active during the details of the summer, right?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] OK. And uh is your member not have any other insurance, am I right?
[AGENT][NEUTRAL] Not with APL.
[CUSTOMER][NEUTRAL] OK. Can I get the reference number for this call?
[AGENT][NEUTRAL] It's my name and today's date.
[CUSTOMER][POSITIVE] Sure, got it and thank you for assisting me today. Have a great day. Bye-bye.
[AGENT][POSITIVE] [PII], it was my pleasure to assist you with that claim denial. Anything else I can help you with?
[CUSTOMER][NEUTRAL] No, nothing else. That's it. Thank you. Bye-bye.
[AGENT][POSITIVE] Thank you for calling APL. Have a wonderful evening.
[CUSTOMER][NEUTRAL] Bye bye.
[AGENT][NEUTRAL] Bye bye.