AccountId: 011433970860
ContactId: 5fbfac2a-0f04-4c63-9679-2695457087cf
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 164029 ms
Total Talk Time (AGENT): 58483 ms
Total Talk Time (CUSTOMER): 62669 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/09/5fbfac2a-0f04-4c63-9679-2695457087cf_20250109T20:15_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII]. I'm calling for the provider to check in additional information about the claim that has been denied. Please note this call will be monitored and recorded for quality and training purposes, [PII].
[AGENT][NEUTRAL] OK, I can look at that claim with you [PII]. um can I get a good call number a callback number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure, it's [PII] and it is a direct line.
[AGENT][NEUTRAL] OK, thank you. Um, do you have the claim number or the policy number?
[CUSTOMER][NEUTRAL] Yes, before that, could be able to spell your name for me for the document purpose?
[AGENT][NEUTRAL] Sure, it's [PII]
[CUSTOMER][NEUTRAL] [PII]?
[AGENT][NEUTRAL] Yeah, [PII].
[CUSTOMER][POSITIVE] Perfect. And the member ID number it shows 02519056.
[AGENT][NEUTRAL] OK, and what was the name and date of birth for the insured?
[CUSTOMER][NEUTRAL] It is yeah.
[CUSTOMER][NEUTRAL] [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you for verifying that [PII]. uh, do you have the claim number?
[CUSTOMER][NEUTRAL] Yes, I have that one. the claim number it shows.
[CUSTOMER][NEUTRAL] 353-9703.
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, yes, so we were unable to pay a benefit as office visits are not covered under this policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So which means office visit service is not covered under the patient's plan, I'm right?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] May I know the patient's planning for this one?
[AGENT][NEUTRAL] Yes, so this is a secondary medical policy. The name is Medlink, M E D L I N K.
[CUSTOMER][NEUTRAL] OK. So for this one, will be able to provide me the call reference number for this claim?
[AGENT][NEUTRAL] Sure, reference number would just be my first name, last initial, and today's date. Uh so my name is spelled uh [PII] last initial is [PII] And was there anything else I could help you with?
[CUSTOMER][POSITIVE] No, I'm good, no, I'm good enough for that information. Have a wonderful day. Bye-bye.
[AGENT][POSITIVE] Yes thank you [PII] you too bye bye.