AccountId: 011433970860
ContactId: 6112aa45-333d-4edb-aff8-2ce037864498
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 414200 ms
Total Talk Time (AGENT): 155386 ms
Total Talk Time (CUSTOMER): 129475 ms
Interruptions: 2
Overall Sentiment: AGENT=0.3, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/15/6112aa45-333d-4edb-aff8-2ce037864498_20250515T20:20_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yeah, hi [PII]. My name is [PII] calling from Bos office to check on a claims.
[AGENT][NEUTRAL] You said it's [PII] or [PII]?
[CUSTOMER][NEUTRAL] Could you please assist me?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII], OK, and you're checking claim status. Do you have the policy number?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] D. Delta 40,700,340.
[AGENT][NEUTRAL] OK, do you have a copy of the ID card? Uh, the APL number will start with a 0.
[CUSTOMER][NEUTRAL] Yeah, I saw that.
[CUSTOMER][NEUTRAL] One second.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you so much for holding. The policy certificate number 00232.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] 981 4.
[AGENT][NEUTRAL] And what's a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] What
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, can you repeat that? I can't understand what you're saying.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] What comes after the [PII]?
[CUSTOMER][NEUTRAL] Yeah, one second.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] No, no, after 8 it's [PII].
[AGENT][NEUTRAL] OK, [PII] is your callback number?
[CUSTOMER][NEUTRAL] No, I'm not asking the policy number. Sorry, apologies.
[AGENT][NEUTRAL] Oh no, I have that that's 232-9814.
[CUSTOMER][NEUTRAL] It's 903.
[AGENT][NEUTRAL] Your phone number?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Patient named [PII].
[CUSTOMER][NEUTRAL] Patient date of birth is [PII].
[AGENT][NEUTRAL] Alright thank you and you said you're checking claim status for what day?
[CUSTOMER][NEUTRAL] Yep
[CUSTOMER][NEUTRAL] November [PII] $383.48.
[AGENT][NEUTRAL] 383-48. OK, one moment.
[CUSTOMER][NEUTRAL] Yeah, yes.
[AGENT][NEUTRAL] And what are the procedure codes on the claim?
[CUSTOMER][NEUTRAL] 99214.
[CUSTOMER][NEUTRAL] Modify 23 and 83036 and after that there is supporting code 3075F 3078F.
[CUSTOMER][NEUTRAL] 3051F and last procedure 36416.
[AGENT][POSITIVE] I got it. Thank, thank you.
[CUSTOMER][NEUTRAL] Did you find the client?
[AGENT][NEUTRAL] I'm still looking.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] And what's the name of the medical group?
[CUSTOMER][NEUTRAL] Yeah, it's a Southeast Medical Group PC.
[AGENT][NEUTRAL] Oh, OK, so I've located the claim and there was no payment made on this claim. Um, I'm showing that the date of service is after the policy was no longer active, so let me give you the claim number and then I'll give you the effective date and the lapse date, OK?
[CUSTOMER][NEUTRAL] That
[AGENT][NEUTRAL] So the claim number is 355.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] 1913.
[AGENT][NEUTRAL] And I show the policy effective date is [PII].
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And the policy is no longer active as of [PII].
[CUSTOMER][NEUTRAL] May I know and what's the claim you need?
[AGENT][NEUTRAL] Why was it denied?
[CUSTOMER][NEUTRAL] Because you provide the client number, right? I mean processed it.
[AGENT][NEUTRAL] OK, what was the date of service of your claim?
[CUSTOMER][NEUTRAL] Yeah, my claim data service is [PII].
[AGENT][NEUTRAL] OK, so this policy termed [PII].
[CUSTOMER][NEUTRAL] But you provide the claim number, right? You have the claim processed it.
[AGENT][NEUTRAL] I did the 355-1913 is the claim number.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] When was the claim processed?
[AGENT][NEUTRAL] I'm showing the received date is [PII]. Proces date is [PII].
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] Thank you so much, [PII]. I have one more data service for the same patient.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Could you please, I have one more data service for the same patient.
[AGENT][NEUTRAL] What is that date of service?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] That denied as well. The claim number is 357.
[AGENT][NEUTRAL] 1051. What's the total charge?
[CUSTOMER][NEUTRAL] Total charge amount of.
[CUSTOMER][NEUTRAL] $298.65.
[AGENT][NEUTRAL] OK, I'm showing the claim was received [PII].
[AGENT][NEUTRAL] Processed [PII].
[AGENT][NEGATIVE] And it denied for the same reason.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][POSITIVE] Thank you so much, and uh.
[CUSTOMER][NEUTRAL] May I know the call reference number?
[AGENT][NEUTRAL] You know, [PII], you can also check your.
[AGENT][NEUTRAL] OK, I can provide that. You can also check your status online at [PII], and you'll use my name in today's date as reference. It's [PII] last [PII] is [PII], did you have any other questions?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][POSITIVE] No, that's all for now. Have a nice day.
[AGENT][POSITIVE] All [PII]. Thank you for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] Yeah, you too.