AccountId: 011433970860
ContactId: 5ecbf621-a60a-4854-97d5-e9d591318a1e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 201619 ms
Total Talk Time (AGENT): 101751 ms
Total Talk Time (CUSTOMER): 49549 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/08/5ecbf621-a60a-4854-97d5-e9d591318a1e_20250508T19:00_UTC.wav
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[AGENT][NEUTRAL] Contacting ATL, my name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hello, my name is [PII] and I'm calling you from provider's office. How are you doing today?
[AGENT][NEUTRAL] Uh, I'm fine. How are you?
[CUSTOMER][POSITIVE] Yeah, I'm doing pretty fine. How are you?
[AGENT][NEUTRAL] Yes, I'm fine. How can I help you?
[CUSTOMER][NEUTRAL] I'm calling in regards of a claim.
[AGENT][NEUTRAL] OK, and what is that policy number, please?
[CUSTOMER][NEUTRAL] 018.
[CUSTOMER][NEUTRAL] 35856.
[AGENT][NEUTRAL] OK, and the patient's name and date of birth please?
[CUSTOMER][NEUTRAL] Yeah, it is [PII], [PII].
[AGENT][POSITIVE] Thank you very much. Is there a callback number I can have in the event that we're disconnected?
[CUSTOMER][NEUTRAL] Yeah, [PII].
[AGENT][NEUTRAL] [PII]. OK, I appreciate that. And uh what is the date of service that we're looking for for me?
[CUSTOMER][NEUTRAL] [PII], build amount $58.
[AGENT][NEUTRAL] OK, let me just check here.
[AGENT][NEUTRAL] OK, your claim number, uh, to this.
[AGENT][NEUTRAL] It's um 358.
[AGENT][NEUTRAL] 6
[AGENT][NEUTRAL] 584.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Now, it looks like we received your claim.
[AGENT][NEUTRAL] Just checking really quickly. It looks like we received your claim, uh, on the [PII]. We processed it on the [PII].
[AGENT][NEUTRAL] Of [PII].
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] Their policy was active from [PII], so the policy was not active on the date of service. So it was active from [PII], um, so it wasn't active on that date of service and it was denied.
[CUSTOMER][NEUTRAL] OK. So you are saying that member's policy is not active on the date of service?
[AGENT][NEUTRAL] Is there anything
[AGENT][NEUTRAL] That is correct. Yes, the, the policy lapsed.
[AGENT][NEUTRAL] As of [PII], and they, they don't have another policy with us.
[AGENT][NEUTRAL] This individual doesn't have another policy with us, so, uh, it wasn't active on that day of service, so we did send that that out to you on the.
[CUSTOMER][NEUTRAL] OK. And can you please once more repeat the claim number?
[AGENT][NEUTRAL] Yes, it's 358.
[AGENT][NEUTRAL] 65
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 84.
[CUSTOMER][NEUTRAL] OK, that's totally fine. And can you spell out your name for me?
[AGENT][NEUTRAL] It's [PII] and the first letter of my last name is [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. And the call reference number for this call, please?
[AGENT][NEUTRAL] It's my name and today's day.
[CUSTOMER][POSITIVE] OK, [PII]. Have a great day. Bye-bye.
[AGENT][POSITIVE] OK, thank you for contacting APO.