AccountId: 011433970860
ContactId: 67285353-6691-4233-800c-67e0f49c5624
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 386040 ms
Total Talk Time (AGENT): 93582 ms
Total Talk Time (CUSTOMER): 181341 ms
Interruptions: 2
Overall Sentiment: AGENT=0.8, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/24/67285353-6691-4233-800c-67e0f49c5624_20250224T16:30_UTC.wav
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[AGENT][NEUTRAL] Morning, thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hello, my name is [PII] calling from provider's office. My last name initial is [PII], and my call back is [PII] and the extension is [PII]. And could you please repeat your name? Could you please spell it out?
[AGENT][NEUTRAL] Sure. My name is [PII].
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] And may I have the name of the facility you're calling from?
[CUSTOMER][NEUTRAL] OK, so how are you today?
[AGENT][POSITIVE] I'm good, thank you.
[CUSTOMER][NEUTRAL] Just a second. The name of the facility is McFarland Medical.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] The member coverage was not in effect on the basis of.
[AGENT][NEUTRAL] OK, and may I have the patient's policy number, Mr. [PII]?
[CUSTOMER][NEUTRAL] It is 018.
[CUSTOMER][NEUTRAL] 07995 letter M as in Mary L as in Lima and the
[CUSTOMER][NEUTRAL] 7.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] So.
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] It's [PII] and the date of birth is.
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] OK, thank you. And how may I assist you with this number, Ms. [PII]?
[CUSTOMER][NEUTRAL] I just need the general claim status for the date of service [PII] and the bill amount $329.99.
[AGENT][NEUTRAL] OK, that's [PII], correct?
[CUSTOMER][NEUTRAL] Yes, and uh before the general claim status, do you have the claim number? Do you have the claim number?
[AGENT][NEUTRAL] What's the claim number?
[CUSTOMER][NEUTRAL] No, uh, may I have the claim number, uh, as I don't have the claim, I have the date of service and the bill amount and patient detail, yep.
[AGENT][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] OK, let me see if I have the claim first, OK, one moment.
[CUSTOMER][POSITIVE] Sure, take your time.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, let me see if this is your claim. Bear with me just a minute.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK. We um processed the claim [PII] and the claim was 353.
[AGENT][NEUTRAL] 313 5.
[CUSTOMER][NEUTRAL] Just a second.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 35, uh, could you please repeat the claim number 353?
[AGENT][NEUTRAL] 3
[AGENT][NEUTRAL] Yes, 353-3135.
[CUSTOMER][NEUTRAL] 353-313-5 and uh may I know the received date and the process date.
[CUSTOMER][NEUTRAL] uh
[AGENT][NEUTRAL] the process date was [PII]. Um, let me get the received date, one moment.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] And
[AGENT][NEUTRAL] That was [PII].
[CUSTOMER][NEUTRAL] OK and uh may I know uh the status of the claim?
[AGENT][NEGATIVE] The claim was denied. The reason for this denial is that the service was surrendered after coverage was terminated.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] 1818908.
[CUSTOMER][NEUTRAL] And may I know uh the dates when the patient's plan was active and when did it uh terminate?
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK, we have an effective date of [PII] and it terminated [PII].
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] [PII] and based on the uh.
[CUSTOMER][NEUTRAL] And uh do you have any other uh information about any other pair which was active on the date of service?
[AGENT][NEUTRAL] None with us, so we don't have any other information.
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I think
[CUSTOMER][NEUTRAL] Yeah I think
[CUSTOMER][NEUTRAL] Just a second.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, so just a second.
[AGENT][NEUTRAL] Yeah, sure.
[CUSTOMER][NEUTRAL] Uh, yeah, so may I have the call reference please?
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in the estate if you will.
[CUSTOMER][POSITIVE] OK. OK, so thank you for your assistance. Have a great day.
[AGENT][POSITIVE] You're welcome and thank you for calling APO. Have a good day as well. Bye-bye, Mr. [PII].
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] You too.
[AGENT][POSITIVE] Thank you.