AccountId: 011433970860
ContactId: 66771e90-415e-4582-a0c4-b4b29c0fcd15
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 204800 ms
Total Talk Time (AGENT): 77640 ms
Total Talk Time (CUSTOMER): 47923 ms
Interruptions: 0
Overall Sentiment: AGENT=2, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/28/66771e90-415e-4582-a0c4-b4b29c0fcd15_20250428T19:22_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling PL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Hi, um, please help me check claim status.
[AGENT][POSITIVE] OK, well, I'll be more than happy to help you with the claim status. May I have your name and a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] My name is [PII]. Contact number is [PII].
[AGENT][NEUTRAL] OK, in case, may I have the member's policy number?
[CUSTOMER][NEUTRAL] 01792144.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] It's to this, um,
[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 how many claims do you have in total today, case?
[CUSTOMER][NEUTRAL] Uh, one claim.
[AGENT][NEUTRAL] All right, and may I have the date of service and the total bill for the member?
[CUSTOMER][NEUTRAL] Date of service, [PII].
[CUSTOMER][NEUTRAL] $260.
[AGENT][NEUTRAL] And is that [PII] or [PII]?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] And can you verify the name of the provider's office on the claim?
[CUSTOMER][NEUTRAL] Sure, provider's office. Macker Clinic Orthopedic Hospital.
[AGENT][NEUTRAL] What is your tax ID?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you for that. Um, it came over Pediatric ENT of Oklahoma, but it has the same tax ID, so thank you for confirming. And I am showing that we received the claim on [PII].
[AGENT][NEUTRAL] The claim number is 357-579-9.
[AGENT][NEUTRAL] And on [PII], the claim was denied because office visits are not covered on this policy.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] How about a reference number for this call?
[AGENT][NEUTRAL] So there's no call reference number, but you can use my name and today's date and again that's [PII], first initial of my last name is [PII].
[CUSTOMER][POSITIVE] All right. Thank you so much. Have a great one. Bye for now.
[AGENT][POSITIVE] You also, was there anything else I can assist you with today?
[CUSTOMER][NEUTRAL] I
[AGENT][POSITIVE] Alright, well, thanks for calling APL. Have a great day.
[CUSTOMER][NEUTRAL] You as well.
[AGENT][POSITIVE] Thank you. Bye-bye.