AccountId: 011433970860
ContactId: 65fb14b6-9644-411d-b3d3-0ac047e295a4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 315260 ms
Total Talk Time (AGENT): 92538 ms
Total Talk Time (CUSTOMER): 76299 ms
Interruptions: 0
Overall Sentiment: AGENT=-0.5, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/24/65fb14b6-9644-411d-b3d3-0ac047e295a4_20250424T12:58_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Yes ma'am. My name is [PII] last initial [PII], calling from First Health of the Carolinas, checking the status of the claim, please.
[AGENT][NEUTRAL] OK, do you have a phone number I can get in case we get disconnected I can call you back?
[CUSTOMER][NEUTRAL] [PII] direct line.
[AGENT][NEUTRAL] And do you have the policy number?
[CUSTOMER][NEUTRAL] U as in Uniform 82240619
[AGENT][NEUTRAL] That's not one of our policy numbers. Do you have their social?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you, hold on one moment please.
[AGENT][NEUTRAL] And what's the name?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII] Date of birth is [PII].
[AGENT][NEUTRAL] Hold on one moment.
[AGENT][NEUTRAL] Thank you, [PII], and you were just needing claim status?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, I can help you with that. What date of service?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Total charge is $258 even.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] What was one of the procedure codes on that bill?
[CUSTOMER][NEUTRAL] 99213
[AGENT][NEUTRAL] OK, we did get that bill in let me see why it was denied.
[AGENT][NEGATIVE] OK, it was denied. Our records indicate that premium for this data service was not received, therefore benefits are not payable.
[AGENT][NEUTRAL] If premium is being paid through Cobra, please contact.
[AGENT][NEUTRAL] Us at [PII] option two.
[AGENT][NEGATIVE] So it was denied because.
[CUSTOMER][NEUTRAL] OK, so the premium wasn't paid.
[AGENT][NEGATIVE] Right, we didn't receive the premium.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] What's the claim number?
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] 355-0614.
[CUSTOMER][NEUTRAL] I'm sorry, and it was received and processed when?
[AGENT][NEUTRAL] Hold on just a moment, I can tell you.
[AGENT][NEUTRAL] Let's see. It was received on [PII].
[AGENT][NEUTRAL] It was denied on [PII].
[CUSTOMER][NEUTRAL] Um, since the EOB is passed 30 days, is there any way I can get it emailed or faxed to me, please?
[AGENT][NEUTRAL] I can fax it to you.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] What's your fax number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] 235.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Attention [PII].
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And how do you spell your name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, I'll fax that to you.
[CUSTOMER][NEUTRAL] OK, and may I get a reference number please?
[AGENT][NEUTRAL] Anything.
[AGENT][NEUTRAL] We do not have reference numbers. You can use my name in today's date. Is there anything else I can help you with?
[CUSTOMER][POSITIVE] No, ma'am. That will be all. Thank you so much. You have a good day.
[AGENT][POSITIVE] Thank you, [PII], for calling APLU as well.
[CUSTOMER][NEUTRAL] Goodbye.
[AGENT][NEUTRAL] Bye-bye.