AccountId: 011433970860
ContactId: 63fece10-3951-49fc-863b-891d9e974371
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 196220 ms
Total Talk Time (AGENT): 78615 ms
Total Talk Time (CUSTOMER): 56531 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/04/63fece10-3951-49fc-863b-891d9e974371_20250304T18:50_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh, this is the Broadway office want to discuss the claim.
[AGENT][NEUTRAL] Yes, I can look at a claim for you. I'm sorry, what did you say your name was?
[CUSTOMER][NEUTRAL] Yes, it is [PII].
[AGENT][NEUTRAL] [PII], OK, uh, can I get a good call back number from you in case we're disconnected please?
[CUSTOMER][NEUTRAL] Yes, a callback number, it is [PII].
[AGENT][NEUTRAL] OK, thank you. And then do you have the policy number?
[CUSTOMER][NEUTRAL] Uh yes, of course, it is 01665215, M like Mary, L like Lima, 8.
[AGENT][NEUTRAL] OK, and uh what was the name and date of birth for the insured?
[CUSTOMER][NEUTRAL] Yes, of course, I remember my name it is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Alright, thank you for verifying that [PII]. What was the date of service for this claim?
[CUSTOMER][NEUTRAL] Uh yes, sir. It is service it is [PII]. The amount, it is $392.43.
[AGENT][NEUTRAL] OK, I'm sorry, um, it kind of cut out there. You said [PII]?
[CUSTOMER][POSITIVE] Yes, correct.
[AGENT][NEUTRAL] OK, and then could you repeat that bill amount?
[CUSTOMER][NEUTRAL] Yes, of course, the bill amount, it is 392.43.
[AGENT][POSITIVE] Got it. OK, thank you so much one moment please.
[AGENT][NEUTRAL] OK, so for this claim, [PII], it looks like uh the one procedure code the 99203 for $302.33 was a duplicate um however the other.
[AGENT][NEUTRAL] 736304 $90.10 that claim is uh that uh would not be covered as it's um not covered when performed in a doctor's office or clinic that service.
[CUSTOMER][NEUTRAL] Uh, may I know the original status of the procedure code that is 99203?
[AGENT][NEUTRAL] Yes, let me find that original claim one moment.
[AGENT][NEUTRAL] OK, so for that procedure code we were unable to pay a benefit as office visits are not covered under this policy.
[CUSTOMER][NEUTRAL] So the office, uh, was it not covered under this policy number. Can I have the car reference number?
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] Yes, that would just be my first name, last initial, and today's date. Uh, so my name is spelled [PII] Was there anything else I could help you with, [PII]?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] Nothing else. Thank you. Bye for now.
[AGENT][POSITIVE] OK, yep, thanks for calling APL.