AccountId: 011433970860
ContactId: 65db1e18-d3a2-41fc-be54-98077968f9b6
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 202800 ms
Total Talk Time (AGENT): 69375 ms
Total Talk Time (CUSTOMER): 56374 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/03/65db1e18-d3a2-41fc-be54-98077968f9b6_20250403T13:16_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from provider office to check on additional information about a claim that has been denied. Please note this call will be monitored and recorded for quality and training purposes.
[AGENT][POSITIVE] OK, [PII], I'll be more than happy to help you with the claim denial clarity. And may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] It's [PII] and it's a dateline.
[AGENT][NEUTRAL] Thank you for that. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] Policy ID I have it is 018358771.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] It is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And may I have the date of service or the claim number for the claim?
[CUSTOMER][NEUTRAL] [PII] and this one is built for.
[CUSTOMER][NEUTRAL] Loading.
[AGENT][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] Sorry for the delay.
[AGENT][NEUTRAL] That's OK.
[CUSTOMER][NEUTRAL] $100 even.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] And do you want me to provide the claim number? I can do that for you.
[AGENT][NEUTRAL] No, it's OK. Does it end in 6532?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, and the claim was denied because services were rendered um after coverage was terminated and what questions did you have?
[CUSTOMER][NEUTRAL] Policy effective date and the term date.
[AGENT][NEUTRAL] So the policy was active from [PII].
[CUSTOMER][NEUTRAL] Any other insurance member has during this data service?
[AGENT][NEUTRAL] Not with APL.
[CUSTOMER][NEUTRAL] With other insurance, are you guys aware of any other insurance were active?
[AGENT][NEUTRAL] So you will have to reach out to the members to see if they have any other insurance in our system, we only show our insurance and their major, so there was no active coverage on your date of service with APL.
[CUSTOMER][NEUTRAL] OK, can I get the call reference number?
[AGENT][NEUTRAL] Sure, there's no call reference number, but you can use my name in today's date. Again, that's [PII].
[CUSTOMER][POSITIVE] Thank you so much for your time. I wish you have a great day. Bye.
[AGENT][POSITIVE] Thank you, [PII]. Was there anything else I can help you with today?